In a new review, researchers analyzed several studies to investigate the harmful effects of antidepressants during the treatment of major depressive disorder in adults ages 65 and older. The systematic review was performed at the University of Connecticut Evidence-based Practice Center (EPC).
Their findings are published in the Journal of the American Geriatrics Society.
Depression is a common and serious problem among older adults. Around 15 to 20 percent of people 65 and older who live independently struggle with symptoms of major depressive disorder. For those in nursing homes, the rates of depression may be as high as 50 percent.
For some, medication is an effective part of treatment for depression. However, when considering whether to prescribe antidepressant medication for older adults, healthcare providers must weigh the safety risks these medications pose against the often modest benefits they can provide compared to other options.
For example, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may increase the risk of falls and fractures in older adults.
The researchers reviewed studies of older adults who had been prescribed serotonin and norepinephrine reuptake inhibitors (SNRIs) to treat the acute phase of major depressive disorder (the earliest stage of the condition, when the goal is to address the symptoms associated with an episode of depression).
They found that taking SNRIs led to a greater number of harmful events compared to those who took a placebo (a harmless sugar pill that should have no effect on health and is prescribed to some study participants to compare their results to results from people who were treated with actual medication). Older adults who took SSRIs experienced about the same number of harmful events as did people who took a placebo.
Overall, the researchers said that taking either SSRIs or SNRIs led to a greater number of people leaving the study due to harmful events of the drugs compared to placebos. They also noted that the drug duloxetine, an SSRI, increased the risk of falls.
“Some of the antidepressants have not been studied in older patients with major depression, and studies don’t often describe specific side effects,” said study co-author Diana M. Sobieraj, Pharm.D., FCCP, BCPS, assistant professor at the University of Connecticut School of Pharmacy.
“Future research in this field is critical to better inform how the safety profiles of different antidepressants compare in older adults.”
Source: American Geriatrics Society