Researchers have shown that older people using new generation medications for depression will be at more risk of death and experiencing various severe medical conditions such as falls, stroke, epilepsy and fractures. The study found that SSRIs (selective serotonin reuptake inhibitors) for depression are more strongly linked to a higher possibility of a number of unfavorable outcomes in individuals above the age of 65 that suffer from depression in contrast to TCAs (tricyclic antidepressants).1✅ JOURNAL REFERENCE
DOI: 10.1136/bmj.d4551
Depression can be a common condition in elderly individuals and medications for depression – mainly SSRIs – tend to be popular. However, not much is known regarding the safety of these medications in elderly individuals. The team of investigators set out to research the possible link between medications for depression and the danger of several potentially life-threatening outcomes in elderly individuals.
60, 746 individuals aged 65 and older who had a recently diagnosed occurrence of depression. Several individuals had additional conditions, including cardiovascular disease and diabetes, and were using several depression meds.
In the time period that patients were monitored, 89 % received a minimum of one prescription for medications for depression, and a total of 1, 398, 359 prescriptions for medications for depression were received. Of these 57% were for SSRIs, 31% for TCAs, 0. 2% for MAOIs (monoamine oxidase inhibitors) and 13. 5% for other depression medications.
Antidepressant use was then analyzed against a number of unfavorable outcomes which include attempted suicide or self harm, all-cause fatality, stroke, heart attack, fractures, falls, epilepsy or seizures and hyponatraemia (high sodium concentrations within the bloodstream).
After adjusting for variables which could impact the outcomes, such as age, sex, intensity of depression, and other conditions in addition to use of other medicines, the researchers determined that SSRIs and medications in the group of other medications for depression were linked to a greater risk of a number of adverse outcomes in contrast to TCAs.
Individuals using SSRIs were more likely to experience a stroke, die, fall or fracture, have a seizure or epilepsy and have hyponatraemia in comparison to TCAs. The group of other antidepressants were linked to a higher risk of death, self-harm or attempted suicide, fracture, stroke and seizures or epilepsy.
Study participants had a 7% chance of death over 1 year when they were not taking depression medication, while the same risks were 8. 1% while taking TCAs, 10. 6% for SSRIs and 11. 4% for the group of other antidepressants. With regard to stroke, 1 year risks were 2. 3%, 2. 6% and 3 % (in comparison to 2. 2% while not taking antidepressants) and for fracture they were 2. 2%, 2. 7% and 2. 8% in comparison to 1. 8%.
Among individual medications mirtazapine, trazodone and venlafaxine had the greatest risk for unfavorable outcomes.
Rates of most unfavorable outcomes were greatest within the first 28 days of antidepressant use as well as in the last 28 days.
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