Fall Risk, SSRIs Association Among Older Adults

With 1 in 5 older adults (OAs) taking an antidepressant medication and a lack of information on fall risk differences between commonly used selective serotonin reuptake inhibitors (SSRIs) available, researchers assessed the comparative safety benefit of sertraline and citalopram/escitalopram at high doses with fall risk.

Study authors utilized data from 2010-2017 Medicare Current Beneficiary surveys and included participants from community-dwelling Medicare beneficiaries aged 65 years and older, who were enrolled in Medicare Part D, and reported taking an SSRI (n = 1023) at baseline.

According to authors of the study, individual SSRI (citalopram or escitalopram vs sertraline) use was compared to the average monthly total standardized daily dose (TSDD) and self-reported falling while controlling for potential confounders.

Findings showed a potential comparative safety benefit of sertraline. In the year following initial medication use, falls were reported by 36.3% of citalopram/escitalopram users and 39.4% of sertraline users.

While the differences were not statistically significant, “users of high TSDD of sertraline (>75 mg) had a lower risk of recurrent falls compared to high TSDD citalopram (>30 mg) or escitalopram (>15 mg) daily for 30 days.”

“Additional comparative studies of individual antidepressants may better inform fall risk management and prescribing for OAs,” concluded study authors.

Reference:
Haddad YK, Kakara R, Marcum ZA. A comparative analysis of selective serotonin reuptake inhibitors and fall risk in older adults. J Am Geriatr Soc. February 8, 2022.
doi: 10.1111/jgs.17686.