Psychiatric Medications Linked to Higher ALS Risk and Poorer Prognosis: JAMA

A new study published in the Journal of American Medical Association showed that prescription usage of sedatives, antidepressants, or anxiety medications was linked to a higher chance of receiving an ALS diagnosis in the future as well as a lower chance of surviving after receiving one.

While a number of studies have indicated that people with a history of mental illnesses are more likely to be diagnosed with amyotrophic lateral sclerosis (ALS), there is little and conflicting evidence linking the use of popular psychiatric drugs to ALS. Thus, this study investigated if the risk and course of ALS are related to the prescribed use of popular psychiatric drugs, such as antidepressants, hypnotics and sedatives, and anxiolytics.

According to the Swedish Motor Neuron Disease Quality Registry, this nationwide register-based case-control study was carried out in Sweden among all patients diagnosed with ALS between January 1, 2015, and July 1, 2023. These patients were matched for age and sex with up to 5 people who did not have ALS, as well as their spouses and full siblings. Following diagnosis, ALS patients were monitored for a median (IQR) of 1.33 (0.64-2.37) years. Prior to the diagnosis of ALS, at least two prescriptions for the psychiatric drugs under study were considered.

Prior use of psychiatric drugs was associated with an increased risk of developing ALS in a study of 1057 ALS cases and 5281 controls (mean age 67.5 years; 53.1% male). Notably, there was a high correlation between the use of hypnotics/sedatives 0–1 year before diagnosis (OR 6.10), anxiolytics 1–5 years prior (OR 1.60), and antidepressants over 5 years prior (OR 1.21).

The use of hypnotics/sedatives (OR 1.21), antidepressants (OR 1.26), and anxiolytics (OR 1.34), after excluding the year before diagnosis, continued to be linked to an elevated risk of ALS. Relative comparisons revealed similar results, allaying worries about family confounding (apart from hypnotics/sedatives). ALS patients who had previously used antidepressants or anxiolytics showed worse survival rates (HRs 1.72 and 1.52, respectively).

Overall, the use of antidepressants, hypnotics and sedatives, or anxiolytics was linked to an increased chance of receiving an ALS diagnosis in the future, according to this countrywide case-control research. Among ALS patients, prediagnostic usage of several of these drugs was likewise linked to a worse survival rate and a quicker functional deterioration.

Reference:

Chourpiliadis, C., Lovik, A., Ingre, C., Press, R., Samuelsson, K., Valdimarsdottir, U., & Fang, F. (2025). Use of common psychiatric medications and risk and prognosis of amyotrophic lateral sclerosis. JAMA Network Open, 8(6), e2514437. https://doi.org/10.1001/jamanetworkopen.2025.14437