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No. 4 (2022)

ТЕРАПИЯ ПСИХИЧЕСКИХ РАССТРОЙСТВ В ПОЗДНЕМ ВОЗРАСТЕ

ANTIDEPRESSANT USE AND RISK OF FALLS IN ELDERLY PATIENTS

https://doi.org/10.21265/PSYPH.2022.74.75.004

Published 2022-12-31

  • А.К. Khasanova

А.К. Khasanova
Russian Medical Academy of Continuous Professional Education, Healthcare Ministry of Public Health of the Russian Federation

Abstract

The prevalence of depressive disorders (DD) among elderly patients ranges from 10 to 20%. Antidepressants (ADs) are the first line of therapy for DD. The use of ADs is common among the older age group: approximately 10% of the elderly and a third of nursing home residents take ADs. One of the most dangerous One of the most dangerous adverse events (AEs) when taking ADs in elderly patients is falls, since the highest risk of death or serious injury as a result of falls threatens the elderly, with age this risk becomes higher. The article presents the main results of clinical studies about AD-induced AEs that increase the risk of falls, and provides a brief overview of current ideas about the problem of AD choice in elderly patients with DD. An increased risk of injury from falls was recorded among all ADs groups. The risk of falls was highest in patients taking selective serotonin-norepinephrine reuptake inhibitors, adjusted hazard ratio (AHR) was 1.54, (95% CI = 1.21–1.92), followed by selective serotonin reuptake inhibitors (AHR = 1.42, 95% CI = 1.19 – 1.71), among which the highest risk had paroxetine (AHR = 1.71, 95% CI = 1.18 – 2.49), and tricyclic ADs (AHR = 1.21, 95% CI = 1.03 – 1.42). tricyclic ADs (AHR = 1.21, 95% CI = 1.03 – 1.42). The article provides recommendations for AD choice in elderly patients in order to minimize the falls risk with taking into account the various falls-related ADs AEs, the STOPPFalls decision-making algorithm and the possibility of using pharmacogenetic testing.

Keywords

antidepressants, falls, depressive disorders, elderly patients, adverse events

PDF (Русский)

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