TUESDAY, July 26 (HealthDay News) -- In the days after they
start taking non-SSRI (selective serotonin reuptake inhibitor)
antidepressants, such as bupropion or venlafaxine, nursing home
residents are at significantly greater risk for falls, according to
a new study.
Researchers found the increased risk for falls also applies to
those who had a dosage increase of their current prescription.
"Our results identify the days following a new prescription or increased dose of a non-SSRI antidepressant as a window of time associated with a particularly high risk of falling among nursing home residents," said study author Dr. Sarah D. Berry, a scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston.
More closely monitoring these nursing home residents for two
days after a change in these antidepressants could help prevent
falls, the researchers said.
In conducting the study, recently published online in the
Journal of Gerontology: Medical Sciences, researchers examined information on 1,181 nursing home residents who had fallen. Specifically, they compared changes in their antidepressant medication one week and two weeks before the fall.
The study found a fivefold increased risk of falls among
residents within two days of a new prescription or an increased
dose of a non-SSRI. The risk of falls diminished each day following
the prescription change, they said.
Berry attributed this increased risk of falls to the following
possible causes:
- Serious cognitive or motor effects associated with non-SSRI
antidepressants that have not yet been fully examined.
- Postural hypotension, a dramatic decrease in blood pressure
upon standing, associated with certain non-SSRIs, such as
trazodone.
- Sedation and coordination problems linked to certain
non-SSRIs.
Newer drugs, including serotonin-norepinephrine reuptake
inhibitors, may also be associated with risk of falls, the
researchers noted.
However, Berry said, "these drugs are effective at treating the
symptoms of depression, and many clinicians are reluctant to
withhold their use based solely on a risk for falls."
Therefore, "nursing home staff should keep a watchful eye on
residents in the days following a non-SSRI antidepressant change to
prevent falls and clinicians should avoid making changes on
weekends or during times when unfamiliar staff is present," Berry
concluded in an institute news release.
More than one-third of the country's nearly 1.6 million nursing
home residents take some type of antidepressant medication, the
study authors pointed out.
More information
The U.S. National Library of Medicine provides more information
on
antidepressants.