16 Jan More Hip Fractures in Elderly on Antidepressants
MedicalResearch.com Interview with:
MSc (Pharm.), PhD student,
Kuopio Research Centre of Geriatric Care and School of Pharmacy
University of Eastern Finland
MedicalResearch.com: What is the background for this study?
Response: Antidepressants are widely used among elderly persons, especially persons with Alzheimer’s disease. They are used not only for treatment for major depression, but for treatment of anxiety, insomnia and chronic pain as well as behavioral symptoms caused by dementia.
However, antidepressants, as well as other psychotropic drugs, may cause sedation, confusion, orthostatic hypotension and hyponatremia, which increase the risk of falling and fractures. Because of changes in pharmacodynamics and pharmacokinetics due to aging, older persons are at the higher risk of those adverse events.
The aim of our study was to investigate whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer’s disease.
MedicalResearch.com: What are the main findings?
Response: We found an increased risk of hip fracture among elderly persons with and without Alzheimer’s disease during the antidepressant use. The increased risk was highest at the beginning of the antidepressant use and remained increased even 4 years later. Association with hip fractures were found with use of all frequently used antidepressant groups.
MedicalResearch.com: What should readers take away from your report?
Response: Older community-dwelling persons are about two times higher risk for hip fracture during the antidepressant use. I recommend the start of antidepressant medication carefully considered, as well as its necessity be monitored regularly, taken account of other risk factors for falling.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further studies are needed to find out whether there is dose-response between antidepressant use and severe adverse events, such as hip fractures among older persons.
It is known that antipsychotics and benzodiazepines are not safe for older persons because their adverse events as well. Further studies should be focusing to find safer options for treatment of behavioral and psychological symptoms of dementia and depression of older persons. Furthermore, effective preventive interventions for hip fractures are recommended to be studied and implemented among elderly persons with and without dementia.
MedicalResearch.com: Is there anything else you would like to add?
Response: I have received a personal research grant from The Finnish Cultural Foundation.
Co-authors’ conflicts of interests have been reported in the original publication.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Antidepressant use and risk of hip fractures among community-dwelling persons with and without Alzheimer’s disease. Sanna Torvinen-Kiiskinen, Anna-Maija Tolppanen, Marjaana Koponen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Heidi Taipale. International Journal of Geriatric Psychiatry, 2017 Jan 5. doi: 10.1002/gps.4667.
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