The study found that selective serotonin reuptake inhibitors (SSRIs) medications for depression are more strongly linked to a higher possibility of a number of unfavorable outcomes in individuals above the age of 65 with depression in contrast to older tricyclic antidepressants (TCAs).
The researchers say the health risks as well as benefits of different medications for depression ought to be carefully considered whenever prescribing these types of medications for depression to elderly individuals and have called for additional analysis to be able to research the results.
Study author Dr Carol Coupland said: “We’ve found some evidence from our study that the older tricyclic medications for depression may be associated with lower risks of several adverse outcomes compared with newer depression meds in older people diagnosed as having depression”
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.
They identified 60, 746 UK individuals aged 65 and above having a recently diagnosed occurrence of depression between 1996 and 2007 using the QResearch primary care database. Several individuals had additional conditions, including cardiovascular disease and diabetes, and were using several depression meds.
Patients were monitored until the end of 2008. In this time period, 89 % (54, 038) 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 per cent were for SSRIs, 31 per cent for TCAs, 0. 2 % for monoamine oxidase inhibitors (MAOIs) and 13. 5 % for other medications for depression.
Antidepressant use was then analyzed against a number of unfavorable outcomes which include all-cause fatality, attempted suicide or self harm, heart attack, stroke, falls, fractures, epilepsy or seizures and high sodium concentrations within the bloodstream (hyponatraemia).
After adjusting for variables which could impact the outcomes, such as age, sex, intensity of depression, 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 die, experience a stroke, fall or fracture, have epilepsy or a seizure and have hyponatraemia in contrast to TCAs. The group of other antidepressants were linked to a higher risk of fatality, attempted suicide or self-harm, stroke, fracture and epilepsy or seizures.
Individuals in the study had a seven % chance of dying over one year when they were not taking medications for depression, 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, one-year risks were 2. 3 %, 2. 6 % and three % (compared with 2. 2 % while not on antidepressants) and for fracture they were 2. 2 %, 2. 7 % and 2. 8 % in contrast to 1. 8 %.
Among individual medications trazodone, mirtazapine and venlafaxine carried the greatest risk for unfavorable outcomes.
Rates of most unfavorable outcomes were greatest within the 28 days after starting the antidepressant as well as in the 28 days after ending.
The researchers furthermore point out that TCAs were given at reduced doses than SSRIs and other medications for depression, which they say “could in part explain our findings.” In addition they caution that differences among patients receiving different medications for depression could be the cause of a number of the associations seen in the study, underlining the need for additional studies to confirm the results.
References for: Newer Medications for Depression Place Elderly at Risk
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