A fall for an elderly person can unfortunately turn into a very serious event. Falls are actually the leading cause of death in people over the age of 65. Their bones are weaker and the impact can be very traumatic. Now, based on new research elderly that are taking antidepressants are even more prone to such a fall, according to the British Journal of Clinical Pharmacology.
Apparently many nursing home residents with dementia are depressed, and selective serotonin uptake inhibitors (SSRIs) are generally considered the treatment of choice. However, in an attempt to help these patients, it is actually causing greater risk for falling, breaking bones, suffering a stroke or even dying.
The Journal actually reports nursing home residents with dementia on average doses of selective serotonin reuptake inhibitors (SSRIs) are three times more likely to have a serious fall than those not taking these drugs.
And the higher the dose, the greater was the risk of sustaining an injury after the fall, the findings showed. But the link was evident even at low doses.
Researchers recorded daily drug use and daily falls in 248 residents diagnosed with dementia from 2006 to 2009. Data was derived from a prescription database and a standardized incident report system. A dataset of 85,074 person days was collected, the average age of participants was 82, and prescription records indicated that antidepressants were used 13,729 (16.1 percent) days—SSRIs were specifically taken on 11,105 of those days, said OnMedica.
Of the 248 residents, 152 (61.5 percent) sustained 683 falls, which translates into about 2.9 falls per person-year; 38 had a single fall, but 114 fell frequently. Of the falls, 220 caused injury: 10 hip fractures; 11 other fractures; 198 graze, open wound, sprain, bruise, and swelling injuries; and one death. Serious fall risks increased two-to-three-fold depending on patient age and SSRI dosage and frequency, noted the British Journal of Clinical Pharmacology.
“Staff in residential homes are always concerned about reducing the chance of people falling and I think we should consider developing new treatment protocols that take into account the increased risk of falling that occurs when you give people SSRIs,” said lead author, Carolyn Shanty Sterke, of the Section of Geriatric Medicine at Erasmus University Medical Center, Rotterdam, The Netherlands, wrote OnMedica.
“Our study also discovered that the risk of an injurious fall increased even more if the residents were also given hypnotic or sedative drugs as sleeping pills,” she added.
“Physicians should be cautious in prescribing SSRIs to older people with dementia, even at low doses,” she concluded.
This team reviewed prescription data on over 60,000 patients aged 65 to 100 who were recently diagnosed with depression and found that about 89 percent received one or multiple antidepressant prescriptions: 57 percent received one SSRI, 31 percent received one tricyclic antidepressant, and the remainder were taking other antidepressants.
The study found that seniors taking SSRIs had an increased risk of dying, suffering a stroke, falling, breaking a bone, or having seizures, versus seniors not on an antidepressant. In one year, 10.6 percent of seniors taking an SSRI—Effexor, Remeron (mirtazapine), and Desyrel (trazodone)—suffered the greatest risks, which were especially high in the first month after starting and in the month following discontinuation of the drug.