Risk of Fall-Related Injuries Associated with Antidepressant Use in Elderly Patients: A Nationwide Matched Cohort Study

Yu-Seon Jung, David Suh, Hang-Seok Choi, Hee-Deok Park, Sun-Young Jung and Dong-Churl Suh
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Yu-Seon Jung: Department of Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
David Suh: School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Hang-Seok Choi: Department of Biostatistics, College of Medicine, Korea University, Seoul 02841, Korea
Hee-Deok Park: Department of Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Sun-Young Jung: Department of Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea
Dong-Churl Suh: Department of Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea

IJERPH, 2022, vol. 19, issue 4, 1-13

Abstract: Previous studies have reported a higher risk of falls among tricyclic antidepressant (TCA) users compared to selective serotonin reuptake inhibitor (SSRI) users, yet SSRIs are known as a safer antidepressant class for use in older adults. This study examined the effects of antidepressant use on the risk of fall-related injuries after classifying antidepressant drugs, polypharmacy, and central nervous system (CNS) drugs by therapeutic classes and identifying factors influencing risk of fall-related injuries. A retrospective matched cohort study based on propensity scores was conducted among older adults, aged 70–89 years, who initiated antidepressant use between 1 January 2012 and 31 December 2014 using the national health insurance system senior cohort in Korea. The proportional hazard Cox regression model was used to examine the association between fall-related injuries and antidepressants. The subgroup analyses were performed to assess the risk of fall-related injuries by the number of concurrently administered medications, therapeutic classes of antidepressants, and CNS class medications. This study found that duloxetine, escitalopram, paroxetine, amitriptyline, imipramine, and trazodone significantly increased the risk of fall-related injuries in older adults. When antidepressants were prescribed to older adults, prescribers carefully considered factors including the dose, number of concurrently administered medications, and therapeutic classes of CNS.

Keywords: antidepressant; fall-related injuries; older adults; concurrent medications; polypharmacy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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