A new study out of Britain has found that selective serotonin reuptake inhibitor (SSRI) antidepressants may pose more risks to elderly patients compared to older drugs called tricyclic antidepressants. SSRI antidepressants, which include drugs such as Prozac and Effexor, are widely prescribed to older patients, but surprisingly, few studies have been conducted to assess their safety in this population.
For this study, which was published in the British Medical Journal, a team of researchers from the Universities of Nottingham and East Anglia tracked more than 60,000 UK patients aged 65 and over with a newly diagnosed episode of depression between 1996 and 2007. The patients, some of whom also suffered from heart disease and diabetes, and were taking several medications, were tracked until 2008.
A total of 89 percent (54,038) of those tracked received at least one prescription for an antidepressant, with more than 1 million prescriptions or antidepressant received by the study subjects. Of these, most -57 per cent – were for SSRI medications. Another 31 percent were prescriptions for tricyclic antidepressants, 0.2 per cent for monoamine oxidase inhibitors (MAOIs) and 13.5 per cent for other antidepressants.
After adjusting for factors that could affect the results, including age, sex, severity of depression, other illnesses and use of other medications, the team found that SSRIs and drugs in the group of other antidepressants were associated with an increased risk of several adverse outcomes compared with tricyclic antidepressants. Patients taking SSRIs were more likely to die, suffer a stroke, fall or fracture, or seizure compared to those not taking an antidepressant. Over the course of a year, 10.6 percent of seniors taking an SSRI died vs. 8 percent of those taking tricyclics and 7 percent of those taking no antidepressant at all. More than 11 percent of those taking other antidepressants died.
Risks were highest in the month after starting the drug, and in the month after stopping. SSRIs associated with the highest risk included Effexor, Remeron and Desyrel.
“This was an unexpected finding, and so further research using other data sources is needed to confirm these findings as well as provide more evidence on the benefits of different antidepressants in this group of people,” Dr Carol Coupland, Associate Professor in Medical Statistics in The University of Nottingham’s Division of Primary Care, said in a statement announcing the study results.