JAMA Netw Open

Psychiatric medications linked to ALS risk, progression

June 11, 2025

Study details: This Swedish registry-based case-control study examined whether common psychiatric medications—specifically antidepressants, anxiolytics, and sedatives—are associated with the risk and prognosis of amyotrophic lateral sclerosis (ALS). Researchers analyzed data from over 1,000 ALS patients, their siblings, spouses, and matched population controls, assessing medication use prior to ALS diagnosis and tracking disease progression.

Results: Among 1,057 ALS cases and 5,281 controls (mean age 67.5 years; 53.1% male), prior use of psychiatric medications was consistently associated with increased ALS risk. Notably, hypnotics and sedatives used within one year before diagnosis showed the strongest association (odds ratio [OR], 6.10), while anxiolytics and antidepressants prescribed up to five years prior were also associated with elevated risk (ORs, 1.60 and 1.21, respectively). Even after excluding the year before diagnosis, all three medication classes remained significantly associated with ALS onset. Additionally, prediagnostic use of anxiolytics (hazard ratio [HR], 1.52) and antidepressants (HR 1.72) was associated with shorter survival post-diagnosis.

Clinical impact: Psychiatric medication use may serve as an early marker—or potentially a modifiable risk factor—for ALS. Clinicians should be aware of this association when evaluating patients with psychiatric histories and consider closer monitoring for neuromuscular symptoms in high-risk individuals.

Source:

Chourpiliadis C, et al. (2025, June 2). JAMA Netw Open. Use of Common Psychiatric Medications and Risk and Prognosis of Amyotrophic Lateral Sclerosis. https://pubmed.ncbi.nlm.nih.gov/40465292/