Possible mechanisms through which antidepressants may increase the risk of AD and related dementias
Mechanism | Description |
---|---|
Immune-inflammatory dysregulation | Drug-induced reduction in levels of anti-inflammatory cytokines (IL-4, IL-10, and IL-13); stimulation of NK and B cell activity; shift in microglial activation towards a neuroinflammatory phenotype |
Increased risk of infection | Possible immunosuppressive effect caused by reductions in CRP, IL-6, and TNF-α; reduction in white cell count; reduction in CD4+ count |
Gut-brain dysbiosis | Drug-induced reduction in gut commensals and increase in pro-inflammatory bacteria in animal models; antibacterial effect on common gut commensals in vitro, including on beneficial species such as Lactobacillus |
Stress axis dysfunction | Failure to normalize HPA axis dysfunction; reduced effectiveness in the presence of HPA axis dysregulation; persistence of ongoing stressors despite relief of depressive symptoms |
Others | Possible acceleration of normal aging in animal models; possible changes in cerebral microvasculature leading to local ischemia; suppression of REM sleep and precipitation of REM sleep behavior disorder |
CRP: C-reactive protein
RPR: Conceptualization, Methodology, Writing—original draft, Writing—review & editing. The author has read and approved the submitted version.
The author declares that he has no conflicts of interest.
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© The Author(s) 2024.