Antidepressants increase fall risk in elderly patients

Nursing home residents with dementia who take SSRIs are three times more likely to suffer injuries through falling, according to a new study from the Netherlands.

The study found that the risk of injurious falls increased with dose strength, and concluded that antidepressants should be used with more caution in the treatment of elderly patients.

As falls are a major cause of serious injury and death in nursing home residents with dementia, the study may influence prescription levels in this customer group.

The researchers collected data on 248 nursing home residents with dementia for 2006 and 2007, using prescription and incident records. The results showed that:

• 152 participants sustained a total of 683 falls, amounting to a mean fall rate of 2.9 per person per year. 220 of the falls resulted in injury or death.

• The risk of an injurious fall increased significantly (by 31%) at 0.25 of the Defined Daily Dose of a SSRI, by 73% at 0.5 DDD, and by 198% at 1 DDD.

• The absolute daily risk for an 80-year-old woman not taking an SSRI was 0.09%, increasing to 0.28% with one DDD of an SSRI.

The study authors concluded that there was a “significant dose-response relationship between injurious falls and the use of SSRIs”.

Lead author Carolyn Shanty Sterke from Erasmus University Medical Centre, Rotterdam, commented: “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.”