Anxiety, depression and sleep meds may increase risk of rare neuro disease
amyotrophic lateral sclerosis
(ALS), a progressive and fatal neurological disorder, according to a new study recently published in JAMA Neurology.
The study examined the use of anxiolytics (used to relieve anxiety), hypnotics and sedatives (used to aid sleep or calm the body), and antidepressants (which work by altering brain chemistry to improve mood). Researchers found that individuals who were prescribed these medications were more likely to be diagnosed with ALS later in life compared to those who did not take them.
Significantly, the study also found that people who used these medications before being diagnosed with ALS had a poorer prognosis, meaning their disease progressed more quickly and survival was shorter. However, experts caution that this finding is based on association, not causation.
"These medications are often prescribed for symptoms such as anxiety, sleep disturbances, or depression, which may appear during the early (prodromal) phase of ALS - well before a formal diagnosis," explained Dr M S Panduranga, senior consultant (neurology), Dharamshila Narayana Superspecialty Hospital. "So, the link may reflect early, subtle neurological changes rather than the harmful effect of the drugs themselves."
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The study, conducted in Sweden, analysed nationwide data from over 1,000 ALS patients and more than 5,000 healthy individuals using the Swedish Motor Neuron Disease Quality Registry. The average age of participants was 67.5 years, and just over half (53.1%) were male.
Dr Manjari Tripathi, professor and head of neurology at AIIMS, explained that most
neuropsychiatric medications
act on the brain's inhibitory pathways, which could interfere with motor neuron activity. "There could also be a toxic effect, especially with long-term, consistent use - not just occasional doses," she said.
"Motor neuron disease leads to slow but steady progression of muscle weakness," she added. "Patients begin to struggle with everyday tasks - buttoning a shirt, combing their hair, walking. Eventually, they become wheelchair bound. Swallowing and speech become difficult, and muscles visibly shrink." One type of ALS, she noted, was the same condition renowned physicist
Stephen Hawking
lived with for decades.
While the exact timeline between medication use and ALS onset remains unclear, Dr Madhukar Bhardwaj, director and head of neurology, Aakash Healthcare, said that a longer history of psychiatric symptoms and prolonged medication use appears to be associated with increased ALS risk.
"In some observational studies, individuals using anxiety or depression medications for more than 10 years showed a stronger link with ALS, especially in younger patients," he said. "It's not yet certain whether this reflects a true biological risk or simply earlier diagnosis due to more medical attention."
"While there's no definitive proof that these medications cause ALS, we need to be cautious, especially when prescribing them to individuals with signs of neurological disease," said Dr Anshu Rohatgi, vice-chairperson (neurology), Sir Ganga Ram Hospital.
Doctors emphasise that patients should not stop their medications on their own. Instead, they should speak with their healthcare providers if they have concerns.
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