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Living with Dementia

SSRIs Boost Risk of Falls in Dementia Patients

  • - Dementia News
  • Jan 21, 2012
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  • Viewed: 2056
Tags: | dementia | selective serotonin reuptake inhibitor | ssri |

Nursing home residents with dementia who use selective serotonin reuptake inhibitors (SSRIs) have an increased risk of having a fall that causes injury compared with those who do not use SSRIs, new research shows.

Further, the risk is dose-dependent, with those using average doses having 3 times the risk compared with nonusers, the authors, led by Carolyn S. Sterke, MSc, from Erasmus University Medical Center, Rotterdam, the Netherlands, report.

“Even at low doses, SSRIs are associated with increased risk of an injurious fall in nursing home residents with dementia,” the authors write.

The use of an SSRI with a hypnotic or sedative increases the risk even further, they add.

The study is published online January 18 in the British Journal of Clinical Pharmacology.

Dementia in Head Injury
Head injury occurs when an outside force hits the head hard enough to cause the brain to move violently within the skull. This force can cause shaking, twisting, bruising (contusion), or sudden change in the movement of the brain (concussion).

In some cases, the skull can break. If the skull is not broken, the injury is a closed head injury. If the skull is broken, the injury is an open head injury.
In either case, the violent jarring of the brain damages brain tissue and tears nerves, blood vessels, and membranes.
The severity of this damage depends on the location and force of the blow to the head.
Damaged brain tissue does not work normally.

The brain has many different functions in the body, and any of them can be disrupted by this damage.
Not all brain damage is permanent. Like all body organs, the brain can heal to a certain extent.
Even this healing may not bring the brain’s function back to what it was before the injury.

Vulnerable Population

“These are frail, elderly patients,” Josepha A. Cheong, MD, professor of psychiatry at the University of Florida College of Medicine, Gainesville, Florida, who was not involved in the research, told Medscape Medical News.

“This study is a reminder that the elderly with dementia are prone to many serious complications, such as falls, and are certainly more sensitive to polypharmacy. They are more likely to be on multiple medications. This is likely to potentiate any adverse drug reactions or side effects, including increased sedation, which can certainly predispose a patient to a fall,” she said.

The study investigators analysed daily drug use and daily falls over a 2-year period, from January 1, 2006, to January 1, 2008, in 248 nursing home residents with dementia. Their mean age of the participants was 82 years.

The investigators extracted the use and dose of SSRIs and other drugs known to increase the risk of falls, including antipsychotics, anxiolytics, hypnotics, sedatives, antidiabetic drugs, beta-blocker eyedrops, cardiovascular drugs, analgesics, anticholinergics, antihistamines, and antivertigo drugs, from the prescription database in the medical records.

The most common SSRI was citalopram, followed by paroxetine, sertraline, and fluvoxamine. The tricyclic antidepressants amitriptyline and nortriptyline were also used; other antidepressants included trazodone and mirtazapine.

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