Citation

Naples JG, Kotlarczyk MP, Perera S, Greenspan SL, Hanlon JT. Am. J. Geriatr. Psychiatry 2016; 24(12): 1221-1227.

Affiliation

Department of Medicine, Division of Geriatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA; Center for Health Equity Research and Promotion, Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. Electronic address: jth14@pitt.edu.

Copyright

(Copyright © 2016, American Association for Geriatric Psychiatry, Publisher Elsevier Publishing)

DOI

10.1016/j.jagp.2016.08.008

PMID

27743842

Abstract

OBJECTIVE: To determine the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women.

METHODS: This is a secondary analysis of the Zoledronic acid in frail Elders to STrengthen bone, or ZEST, trial data treated as a longitudinal cohort in 181 frail, osteoporotic women aged ≥65 years in long-term care. The primary exposure was individual non-TCA/non-SSRI antidepressants (i.e., serotonin norepinephrine reuptake inhibitors, mirtazapine, trazodone, and bupropion) at baseline and 6 months. The main outcome was recurrent (at least two) falls within 6 months after antidepressant exposure. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were derived using a generalized estimating equations model.

RESULTS: At least 15% of women experienced recurrent falls between 0-6 and 6-12 months. At baseline and 6 months, 18.2% and 6.9% had a non-TCA/non-SSRI antidepressant, respectively. Adjusting for demographics, health status, and other drugs that increase risk of falls, non-TCA/non-SSRI antidepressant exposure significantly increased the risk of recurrent falls (AOR: 2.14; 95% CI: 1.01-4.54). Fall risk further increased after removing bupropion from the non-TCA/non-SSRI antidepressant group in sensitivity analyses (AOR: 2.73; 95% CI: 1.24-6.01).

CONCLUSIONS: Other antidepressant classes may not be safer than TCAs/SSRIs with respect to recurrent falls in frail older women.

Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Language: en