Science Current Events | Science News | Brightsurf.com
 

Nursing home residents at heightened risk of falling in the days following

July 18, 2011
Increased surveillance over 48-hour period may decrease falls

BOSTON-Nursing home residents taking certain antidepressant medications are at an increased risk of falling in the days following the start of a new prescription or a dose increase of their current drug, according to a new study by the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School.

Published online in the Journal of Gerontology: Medical Sciences, the study found that nursing home residents have a fivefold increased risk of falling within two days of a new prescription for or an increased dose of a non-SSRI (selective serotonin reuptake inhibitor) antidepressant such as bupropion or venlafaxine. The findings suggest that nursing home staff should closely monitor these residents following a prescription change to prevent potential falls.

"Our results," says lead author Sarah D. Berry, M.D., M.P.H., a scientist at the Institute for Aging Research, "identify the days following a new prescription or increased dose of a non-SSRI antidepressant as a window of time associated with a particularly high risk of falling among nursing home residents."

The risk of falls, she says, may be due to acute cognitive or motor effects that have not yet been fully investigated. Certain non-SSRIs, such as trazodone, can cause postural hypotension, a dramatic decrease in blood pressure upon standing that may contribute to falls. Other non-SSRIs, like venlafaxine, can cause sedation and coordination problems that may lead to falls.

According to some estimates, more than one-third of the country's nearly 1.6 million nursing home residents take some type of antidepressant medication. Several previous studies have implicated antidepressants, including both SSRIs, such as paroxetine and sertraline, and non-SSRIs, as a risk factor for falls, especially among older adults; however, it is unclear if the risk accrues during the duration of use or if there are acute risks associated with the initiation or change in dose of a prescription.

Both tricyclic antidepressants and SSRIs, the most commonly prescribed antidepressant medications, have been associated with up to a sixfold increased risk of falls among nursing home residents in other studies. Newer drugs, including serotonin-norepinephrine reuptake inhibitors, may also be associated with falls risk. Regardless, says Dr. Berry, "these drugs are effective at treating the symptoms of depression, and many clinicians are reluctant to withhold their use based solely on a risk for falls."

Although many studies have examined chronic antidepressant use as a risk factor for falls, few have considered the short-term effects of a change in antidepressant prescription. Dr. Berry's study, called a case-crossover study, examined 1,181 residents of a Boston-area nursing home who fell, comparing the frequency of antidepressant changes during a "hazard" period (1-7 days before a fall) with the frequency of antidepressant changes during a control period (8-14 days before a fall). Information on falls was collected using the facility's federally-mandated computerized incident reports. The risk of falls was greatest within a two-day period of a change in a non-SSRI prescription (either new or existing), while no association was found between SSRIs and falls. The risk of falls diminished each day following the prescription change.

In light of her findings, says Dr. Berry, an instructor in medicine at Harvard Medical School, "nursing home staff should keep a watchful eye on residents in the days following a non-SSRI antidepressant change to prevent falls and clinicians should avoid making changes on weekends or during times when unfamiliar staff is present."

###

The study was funded by a grant from the National Institute on Aging, the Hartford Geriatrics Health Outcomes Research Scholars Awards Program, and the Men's Associates of Hebrew SeniorLife.

Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making.

Founded in 1903, Hebrew SeniorLife, an affiliate of Harvard Medical School, is a nonprofit, nonsectarian organization devoted to innovative research, health care, education and housing that improves the lives of seniors. For more information, please visit www.hebrewseniorlife.org.

Hebrew SeniorLife Institute for Aging Research


Related Antidepressant Current Events and Antidepressant News Articles


Mindfulness-based therapy rather than antidepressants to prevent depression relapse?
Researchers from Plymouth University Peninsula Schools of Medicine and Dentistry are part of a team led by the University of Oxford, who have carried out new research that suggests mindfulness-based cognitive therapy (MBCT) could provide an alternative non-drug treatment for people who do not wish to continue long-term antidepressant treatment.

Mindfulness-based therapy could offer an alternative to antidepressants for preventing depression relapse
Mindfulness-based cognitive therapy (MBCT) could provide an alternative non-drug treatment for people who do not wish to continue long-term antidepressant treatment, suggests new research published in The Lancet.

Wristband that measures rest, activity schedule may help predict response to antidepressants
A wristband that records motion throughout a 24-hour cycle may be an inexpensive, safe way to determine which patients with major depressive disorder will respond best to commonly prescribed drugs such as Prozac.

Babies exposed to narcotic pain relievers more likely to experience withdrawal
Neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants following birth, has historically been associated with illicit drug use among pregnant women.

Easing the pain
The combination of two well-known drugs will have unprecedented effects on pain management, says new research from Queen's.

Common antidepressant increased coronary atherosclerosis in animal model
A commonly prescribed antidepressant caused up to a six-fold increase in atherosclerosis plaque in the coronary arteries of non-human primates, according to a study by researchers at Wake Forest Baptist Medical Center. Coronary artery atherosclerosis is the primary cause of heart attacks.

Adolescent mental healthcare improved through pediatric primary care training
Training pediatric primary care providers to screen and assess depression and suicide risk in adolescent patients improved providers' confidence and knowledge of these conditions and increased frequency of screenings for this critical patient population.

Electroconvulsive therapy changes key areas of the human brain that play a role in memory, emotion
Although scientists know that depression affects the brain, they don't know why some people respond to treatment while others do not.

Publication bias and 'spin' raise questions about drugs for anxiety disorders
A new analysis reported in JAMA Psychiatry raises serious questions about the increasingly common use of second-generation antidepressant drugs to treat anxiety disorders.

A surprising source of serotonin could affect antidepressant activity
Depression affects an estimated 350 million people worldwide and poses a major public health challenge, according to the World Health Organization. Researchers have discovered an unconventional way that serotonin is released from neurons that could play an important role in the mechanism through which antidepressant drugs work.
More Antidepressant Current Events and Antidepressant News Articles

The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and "Addiction"

The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and "Addiction"
by M.D. Joseph Glenmullen M.D. (Author)


With the FDA's warning that antidepressants may cause agitation, anxiety, hostility, and even violent or suicidal tendencies, these medications are at the forefront of national legal news. Harvard physician Joseph Glenmullen has led the charge to warn the public that antidepressants are overprescribed, underregulated, and, especially, misunderstood in their side and withdrawal effects. Now he offers a solution!

More than twenty million Americans -- including over one million teens and children -- take one of today's popular antidepressants, such as Paxil, Zoloft, or Effexor. Dr. Glenmullen recognizes the many benefits of antidepressants and prescribes them to his patients, but he is also committed to warning the public of the dangers associated with overprescription. Dr....

The Anti-Depressant Fact Book: What Your Doctor Won't Tell You About Prozac, Zoloft, Paxil, Celexa, and Luvox

The Anti-Depressant Fact Book: What Your Doctor Won't Tell You About Prozac, Zoloft, Paxil, Celexa, and Luvox
by Peter R. Breggin (Author)


Known as "the Ralph Nader of psychiatry," Dr. Peter Breggin has been the medical expert in countless court cases involving the use or misuse of psychoactive medications. This unusual position has given him unprecedented access to private pharmaceutical research and correspondence files, information from which informs this straight-talking guide to the most prescribed and controversial category of American drugs: antidepressants. From how these drugs work in the brain to how they treat (or don't treat) depression and obsessive-compulsive, panic, and other disorders; from the documented side and withdrawal effects to what every parent needs to know about antidepressants and teenagers, The Anti-Depressant Fact Book is up-to-the minute and easy-to-access. Hard-hitting and enlightening, every...

The Emperor's New Drugs: Exploding the Antidepressant Myth

The Emperor's New Drugs: Exploding the Antidepressant Myth
by Irving Kirsch (Author)


Irving Kirsch has the world doubting the efficacy of antidepressants. Based on fifteen years of research, The Emperor's New Drugs makes an overwhelming case that what the medical community considered a cornerstone of psychiatric treatment is little more than a faulty consensus. But Kirsch does more than just criticize: He offers a path society can follow to stop popping pills and start proper treatment.

Medications for Anxiety & Depression - A guide to choosing the antidepressant or anti-anxiety medication that's right for you

Medications for Anxiety & Depression - A guide to choosing the antidepressant or anti-anxiety medication that's right for you


Are you confused about which antidepressant is right for you? Would you like to learn all the important information on all of the antidepressants currently available?All medications are not equal. Just like a carpenter, you need the right tool for the job. Don't just rely on your doctor - take a proactive role in managing your recovery!Unfortunately, doctors tend to be incredibly busy. Sometimes they just don't have the time to get all the details they need to choose the right medication for you. This means that very often, you will just be prescribed the drug that your doctor has the most experience in. This may or may not be the right tool for the job.Depression and anxiety are incredibly varied conditions. Some people are "anxious depressed" whereas others can be more "low...

The Soft Landing Method for Quitting Antidepressants - How to successfully get off antidepressants the right way, first time

The Soft Landing Method for Quitting Antidepressants - How to successfully get off antidepressants the right way, first time


Completely updated for 2014 with the latest advanced in our understanding of SSRI DiscontinuationEverything you need to know to ensure you have a "soft landing" as you come off antidepressantsA guide to getting off SSRI antidepressants and starting your drug free life again, from Benjamin Kramer, best-selling author of "Brain Renovation".In this clear and concise guide, Benjamin Kramer gives you an easy to implement blueprint for coming off antidepressants such as SSRIs (Selective Serotonin Re-uptake Inhibitors) using a variety of little-known techniques and tips.With a scientifically-designed tapering plan, including the use of certain other drugs and supplements where required, you can avoid coming in for landing too hard and crashing. Done properly, you CAN have a soft landing off...

Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting

Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting
by Michael Banov (Author)


Walks readers with depression through a personalized process to help them make the right choice about starting, staying on, and stopping antidepressants.

Dr. Shipko's Informed Consent for SSRI Antidepressants

Dr. Shipko's Informed Consent for SSRI Antidepressants


I am writing this eBook to share the key information that I discuss with patients in consultation before starting or stopping a serotonin reuptake inhibitor (SSRI) antidepressant. ‘Informed Consent’ is not intended to be a comprehensive book about these drugs, rather, it duplicates the information that I typically provide to my patients when I see them in consultation. If you are contemplating starting or stopping an SSRI antidepressant, then you will find this information helpful.

Natural Prozac: Learning to Release Your Body's Own Anti-Depressants

Natural Prozac: Learning to Release Your Body's Own Anti-Depressants
by Joel C. Robertson (Author)


'THE DRUG-FREE ALTERNATIVE TO ENDING DEPRESSION'"Depressed people cannot simply 'cheer up.' They suffer from a chemical imbalance in their central nervous system that is the source of their depression. Fortunately, balance can be restored, and that is the aim of this book…I will demonstrate how common behaviours can either maintain a brain-chemical imbalance and thus sustain depression or be used to balance our brain chemicals in order to overcome depression."- from 'Natural Prozac'For millions of people, depression is an inescapable fact of daily life. Now, 'Natural Prozac' reveals how to break the debilitating grip of clinical depression by ending self-destructive patterns of thought and behaviour. This safe, easy-to-follow, and scientifically proven approach to natural healing...

The Evidence-Based Guide to Antidepressant Medications

The Evidence-Based Guide to Antidepressant Medications
by Anthony J. (Author), Rothschild (Author)


The second book in the Evidence-Based Guides series, The Evidence-Based Guide to Antidepressant Medications, provides a clear reference to the current knowledge and evidence base for the use of antidepressants among a variety of patients across a wide range of disorders. Today, in part due to the newer antidepressants, which have fewer side effects and less toxicity in overdose, many non mental health professionals feel comfortable prescribing antidepressants. Antidepressants are prescribed for many patients in addition to those who have major depressive disorder, including patients with bipolar disorder, posttraumatic stress disorder, schizophrenia, and personality disorders, as well as those with medical illnesses. In addition, antidepressants are increasingly being prescribed by...

Rhodiola Rosea - Nature's premier anti-stress and anti-depressant herb

Rhodiola Rosea - Nature's premier anti-stress and anti-depressant herb


What supplement can treat depression, chronic stress, anxiety, along with improving endurance and improving cardiac function?In his continuing series of quick, easy-to-read guides on the world's best supplements and natural therapies, James Lee now introduces rhodiola rosea, a herb he has covered briefly in previous books such as "Hack Your Brain".Some natural therapies are more hype than reality, however rhodiola has an impressive amount of clinical research backing that demonstrates its effectiveness for treating a range of conditions.In particular, if you are suffering from low mood, lack of energy, lack of motivation or decreased mental performance, rhodiola may be worth investigating.In this quick guide, Lee covers - What is it?What has it been shown to be helpful in treating?How...

© 2015 BrightSurf.com