Fall Risk Among Older Adults With Depression Lower With Use of First-Line Antidepressants: Study

Findings may provide important treatment guidance, suggesting that the risk of falls and injuries may be less with first-line antidepressants than among older adults receiving no treatment for their depression

While prior studies have suggested that side effects of certain antidepressants may increase the risk of falls and injuries for older adults, new research suggests that those individuals may actually be less likely to experience a fall-related injury than other elderly adults receiving no treatments for their depression.

Treating older patients with depression can be tricky, since many first-line antidepressants are known to cause dizziness, which is extremely dangerous for the elderly. However, depression itself is also an independent risk factor for a person’s chances of having a fall.

In the findings of a new study published in the journal JAMA Network Open on August 26, Grace Hsin-Min Wang and other researchers from the University of Florida indicate that first-line antidepressants were actually associated with lower fall risks for older adults with depression, which may provide valuable insights for medical providers considering the best course of treatment.

Numerous studies have linked the use of antidepressants and falls among older patients, leading to mixed opinions in the medical community about the best course of treatment for those individuals, who may be left with life-threatening injuries or reduced quality of life if they suffer a fall injury..

A study published in 2019 in the journal JAMA Psychiatry indicated that antidepressants increased risk of hip fracture for older adults, while similar findings in a 2017 study determined that these individuals faced a 60% higher risk of suffering hip fractures from falls while taking an antidepressant.

Other research has highlighted the risk of falling when antidepressants are used in older patients who suffer from dementia, indicating that side effects of drugs like Paxil and Prozac tripled the risk of nursing home falls among residents with memory issues.

It has been suggested that these findings may be because drugs like antidepressants reduce brain function among older people, making them more disoriented and more likely to fall.

However, Wang’s study seems to provide better news for older adults who would benefit from taking first-line antidepressants.

New Data Indicates First-Line Antidepressants May Decrease Fall Risk

Using Medicare claims data involving beneficiaries over 65 years old from 2016 to 2019, Wang studied 102,000 patients, focusing on the use of first-line antidepressants, including Zoloft, Lexapro, Celexa, Remeron, Cymbalta, Prozac, Wellbutrin, Paxil and Effexor.

The data indicated that first-line antidepressants showed a decreased rate of falls and fall-related injuries, such as hip fractures and concussions. Conversely, psychotherapy alone was not linked to an increase or decrease in the fall risk among older adults.

Roughly one-third of older adults in the U.S. suffer from depression, and it is often treated with therapy and antidepressants. However, researchers highlight that this study’s findings may help improve safety profiles for older patients.

Following the results of this study, doctors could give better recommendations for treatment when diagnosing older patients with depression, especially since nearly half of the patients diagnosed with depression didn’t receive referrals for therapy or prescriptions for antidepressants.