Anti Depressants Raise Risk Of Falling Over

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Main Category: Seniors / Aging
Article Date: 20 Jan 2012 - 16:00 PST


British Journal of Clinical Pharmacology published an article this week showing increased risk of falling over, for nursing home residents on anti depressants. Figures show that those with dementia who use standard doses of selective serotonin reuptake inhibitors (SSRIs) are three hundred percent more likely to sustain an injury from falling, than similar people who don't use these drugs.

Selective serotonin reuptake inhibitors (SSRIs) are generally considered to be the treatment of choice for nursing home patients with depression. Lead author Carolyn Shanty Sterke, who works in the Section of Geriatric Medicine at Erasmus University Medical Center, Rotterdam, The Netherlands said :

"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 ... Physicians should be cautious in prescribing SSRIs to older people with dementia, even at low doses."

With elderly patients having more brittle bones and weaker tendons, ligaments and less muscle mass, falls are a major problem in nursing homes with one out of three tumbles causing an injury.

Sterke and colleagues carried out this research by recording the daily drug use and daily falls in 248 nursing home residents with dementia from 1 January 2006 until 1 January 2008. In total, they collected a dataset of 85,074 person-days. The mean age of the participants was 82 years, and the prescription records showed that antidepressants had been used on 13,729 (16.1%) days, with SSRIs being used on 11,105 of these days. Data about the residents' day-by day drug use came from a prescription database, and information on falls and subsequent injuries came from a standardized incident report system. The incident reports showed that :

• 152 of the 248 residents (61.5%) sustained 683 falls.
• A fall incidence of 2.9 falls per person-year.
• Thirty-eight residents had a single fall, but 114 fell frequently.
• Two hundred twenty falls resulted in injury or death.
• Injuries included :
• 10 hip fractures
• 11 other fractures
• 198 were injuries such as grazes, open wounds, sprains, bruises, and swellings.
• One person died after falling.

The risk of having an injurious fall increased threefold for residents taking SSRIs, from an absolute daily risk of 0.09% for a female aged 80 not taking an SSRI, to 0.28% for a female aged 80 taking one defined daily dose of SSRIs. Similar increases in absolute daily risk were found for both men and women, for different ages. Sterke concluded :

"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."

Written by Rupert Shepherd
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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