Antidepressants Linked to Increased Risk of Fall

Most of us are familiar with the many side effects that come with taking antidepressants but in a recent study published in the Journals of Gerontology it was revealed that nursing home residents were at a much higher risk of suffering a fall within the first few days of starting or increasing the dose of certain antidepressants

 

Falls are a serious health risk for the elderly that can often times result in serious injury or even death. For this reason it is extremely important that seniors know when a medication they are taking can make them vulnerable to falling down. Several years ago a study was released in the archives of Internal Medicine linking selective serotonin reuptake inhibitors (SSRI’s) like Prozac and Paxil with a greatly increased risk of falling but in this new study a whole new risk was discovered. Patients who started or increased their doses of non-SSRIs such as Effexor or Wellbutin saw a 5 times higher risk of fall for a very specific window of time.

 

The study was conducted by assessing 1,181 nursing home residents who had suffered a fall. The researchers looked at changes in their antidepressant medications 1 week and 2 weeks before they fell. What they found was that between 2 and 5 days after starting or increasing a dose of a non-SSRI antidepressant their risk of falling and suffering a fracture increased 5 fold. By the 5th day after the change the risk factor returns to normal perhaps because the patient has adjusted to the change.

 

Researchers are still hypothesizing what the contributing factors to the increased risk might be but they believe it has to do with one or more of the following factors.

  • A dramatic drop in blood pressure upon standing. This is a common side effect of many non-SSRIs such as trazodone.
  • Another common side effect of some non-SSRIs is feelings of sedation or drossiness; this could lead to coordination problems that could increase the risk of a fall.
  • Researchers are still looking into certain motor or cognitive effects that could be contributing to the increased risk.

 

With more than one-third of the over 1.5 million people living in nursing homes taking some type of antidepressant medication and nursing homes suffering from a chronic lack of adequate staff these risks can create a serious dilemma for care givers. Do you treat the depression and increase the likelihood of injury or take people off medications that could improve their quality of life in order to protect them from a fall.


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