Psychiatric medications linked to risk and progression of ALS: Study
A recent case-control study published in the Journal of American Medical Association found a significant association between the use of common psychiatric medications (antidepressants, anxiolytics, and sedatives), which increased risk of developing amyotrophic lateral sclerosis (ALS) and faster disease progression following diagnosis.
Despite earlier studies pointing to a possible connection between psychiatric disorders and later ALS diagnosis, evidence tying psychiatric medications to ALS risk has been limited. This study by Charilaos Chourpiliadis and team looked specifically at drug use patterns before the disease was diagnosed. The study analyzed nationwide health data from 2015 to 2023 and included a total of 1,057 individuals diagnosed with ALS, compared against more than 5,200 matched individuals without ALS, as well as their siblings and spouses.
The research found that individuals prescribed psychiatric medications had a significantly higher risk of developing ALS. Those who had been prescribed hypnotics and sedatives within the year leading up to their diagnosis were over 6 times more likely to be diagnosed with ALS when compared to those without such prescriptions (odds ratio [OR] 6.10; 95% CI, 3.77–9.88).
Even when this study excluded the year directly before ALS diagnosis, to rule out early, undetected ALS symptoms prompting psychiatric treatment, the use of anxiolytics (OR 1.34), antidepressants (OR 1.26), and sedatives (OR 1.21) still showed a modest but statistically significant increase in ALS risk.
To account for possible genetic or shared environmental factors, the study also compared ALS patients to their siblings and spouses. The findings remained consistent, especially for anxiolytics and antidepressants, suggesting that familial factors alone could not fully explain the association. However, the link between sedative use and ALS was weaker when familial controls were considered.
This study also observed that prediagnostic use of psychiatric medications was associated with shorter survival after ALS diagnosis. The patients who had taken anxiolytics or antidepressants prior to diagnosis had significantly worse outcomes. The risk of mortality or need for invasive ventilation was 52% higher among anxiolytic users (HR 1.52) and 72% higher among antidepressant users (HR 1.72), when compared to patients who had not used those medications.
Overall, these findings suggest that psychiatric medication use may not only be a marker of underlying risk but also a potential factor influencing ALS progression. The study does not confirm causality, but, urges further investigation to determine whether psychiatric medications contribute directly to ALS development or are indicators of prodromal symptoms.
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
