New research shows selective serotonin reuptake inhibitors (SSRIs), can significantly disrupt sleep quality in elderly individuals and may contribute to early signs of neurodegeneration that may progress to dementia. These findings were presented at the Institute of Psychiatric Services (IPS): The Mental Health Services 2016 Conference. The research review included 10 studies that were published in the last 5 years. The studies included systemic reviews, retrospective studies, and prospective studies. All patients were at least 50 years of age and taking an antidepressant (most commonly an SSRI). According to Muhammad Tahir, MD, psychiatry resident, SUNY Upstate Medical University, Syracuse, New York, “SSRIs increase sleep latency in the elderly and decrease REM [rapid eye movement] sleep duration and are also associated with REM sleep behavioral disorders, including nightmares. So our literature review suggests that we should be careful about using SSRIs in the elderly population and not underestimate the effectiveness of psychotherapy and other holistic care approaches for the elderly.” Research revealed that not only do SSRIs change sleep architecture in older people, they also seem to increase the risk for REM behavioral disorders. These behavioral disorders are characterized by normal brain activity, but the body is agitated and is not sleeping. The researchers believe this may be an early sign of neurodegeneration. Peter Yellowlees, MD, professor of psychiatry at the University of California made the following comment: "In the elderly, these doses should be a maximum of half of the usual dose prescribed for younger patients.” Many patients are simply given too high a dose of an antidepressant. It is also important to remember that diet and lifestyle modifications, as well as nutrient supplementation can be wonderful for improving depression and anxiety. Sometimes prescription medication is not necessary. I have written about natural options for improving mental health in my book Help for Depression and Anxiety. Reference