Dose-response relationship between selective serotonin re-uptake inhibitors and injurious falls: A study in nursing home residents with dementia

British Journal of Clinical Pharmacology

Volumn 73, Issue 5, 2012, Pages 812-820

  Sterke, Carolyn S ^a,b   Ziere, Gijsbertus ^a   van Beeck, Ed F ^a   Looman, Caspar W N ^a   Van der Cammen, Tischa J M ^a  

^a ERASMUS MEDICAL CENTER   (Netherlands)

^b De StromenOpmaatGroep   (Netherlands)

Author keywords

Dementia; Dose response; Falls; Nursing homes; Selective serotonin re uptake inhibitors

Indexed keywords

AMITRIPTYLINE; CITALOPRAM; FLUVOXAMINE; HYPNOTIC AGENT; MIRTAZAPINE; NORTRIPTYLINE; PAROXETINE; SEDATIVE AGENT; SEROTONIN UPTAKE INHIBITOR; SERTRALINE; TRAZODONE;

AGED; ARTICLE; DATA BASE; DEMENTIA; DISEASE ASSOCIATION; FALLING; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAL INFORMATION; NURSING HOME PATIENT; PRESCRIPTION; PRIORITY JOURNAL; RETROSPECTIVE STUDY; RISK ASSESSMENT;

ACCIDENTAL FALLS; AGED; AGED, 80 AND OVER; DEMENTIA; DEPRESSION; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; HOMES FOR THE AGED; HUMANS; MALE; NETHERLANDS; NURSING HOMES; RETROSPECTIVE STUDIES; RISK FACTORS; SEROTONIN UPTAKE INHIBITORS; SEVERITY OF ILLNESS INDEX;

EID: 84859415437     PISSN: 03065251     EISSN: 13652125     Source Type: Journal    
DOI: 10.1111/j.1365-2125.2011.04124.x     Document Type: Article

References (44)

1. Heinze C, Halfens RJ, Dassen T. Falls in German in-patients and residents over 65 years of age. J Clin Nurs 2007; 16: 495-501.
2. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med 1994; 121: 442-51.
3. Nurmi I, Luthje P. Incidence and costs of falls and fall injuries among elderly in institutional care. Scand J Prim Health Care 2002; 20: 118-22.
4. Dijcks BP, Neyens JC, Schols JM, van Haastregt JC, de Witte LP. Falls in nursing homes: on average almost two per bed per year, resulting in a fracture in 1.3. Ned Tijdschr Geneeskd 2005; 149: 1043-7.
5. Neyens JC, Dijcks BP, Twisk J, Schols JM, van Haastregt JC, van den Heuvel WJ. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT). Age Ageing 2009; 38: 194-9.
6. CBO, Dutch Institute for Healthcare Improvement. Guideline for Prevention of Fall Incidents in Old Age. Alphen aan den Rijn: Van Zuiden Communications BV, 2004. (In Dutch).
7. Starkstein SE, Jorge R, Mizrahi R, Robinson RG. The construct of minor and major depression in Alzheimer's disease. Am J Psychiatry 2005; 162: 2086-93.
8. Mann E, Kopke S, Haastert B, Pitkala K, Meyer G. Psychotropic medication use among nursing home residents in Austria: a cross-sectional study. BMC Geriatr 2009; 9: 18.
9. Nijk RM, Zuidema SU, Koopmans RT. Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia. Int Psychogeriatr 2009; 21: 485-93.
10. Nishtala PS, McLachlan AJ, Bell JS, Chen TF. Determinants of antidepressant medication prescribing in elderly residents of aged care homes in Australia: a retrospective study. Am J Geriatr Pharmacother 2009; 7: 210-9.
11. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003; 163: 2716-24.
12. Arfken CL, Wilson JG, Aronson SM. Retrospective review of selective serotonin reuptake inhibitors and falling in older nursing home residents. Int Psychogeriatr 2001; 13: 85-91.
13. Richards JB, Papaioannou A, Adachi JD, Joseph L, Whitson HE, Prior JC, Goltzman D. Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med 2007; 167: 188-94.
14. Ziere G, Dieleman JP, van der Cammen TJ, Hofman A, Pols HA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants are associated with an increased risk of nonvertebral fractures. J Clin Psychopharmacol 2008; 28: 411-7.
15. Vestergaard P, Rejnmark L, Mosekilde L. Selective serotonin reuptake inhibitors and other antidepressants and risk of fracture. Calcif Tissue Int 2008; 82: 92-101.
16. Sterke CS, Verhagen AP, van Beeck EF, van der Cammen TJ. The influence of drug use on fall incidents among nursing home residents: a systematic review. Int Psychogeriatr 2008; 20: 890-910.
17. American Psychiatric Association. In: Diagnostic and Statistical Manual of Mental Disorders, 4th edn. (DSM-VI-TR). Washington, DC: American Psychiatric Association, 2000.
18. Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-9.
19. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 1999; 47: 40-50.
20. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999; 47: 30-9.
21. van der Velde N, Stricker BH, Pols HA, van der Cammen TJ. Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol 2007; 63: 232-7.
22. Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, Marra CA. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med 2009; 169: 1952-60.
23. WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. 2002. Available at (last accessed 20 August 2005).
24. Flockhart DA. Drug interactions: cytochrome P450 drug interaction table. Indiana University School of Medicine. 2007. Available at (last accessed 21 April 2011).
25. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664-72.
26. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001; 54: 837-44.
27. Kellogg International Work Group on the prevention of falls by the Elderly. The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull 1987; 34: (Suppl. 4): 1-24.
28. Arcares, inter-branch organization nursing homes and care homes. Incidence Registration System (MIC). Utrecht: Arcares, 2002. (In Dutch).
29. LPZ Project Group. The Dutch National Prevalence Survey of Care Problems (LPZ). Maastricht: Department of Health Care and Nursing Sciences, 2008. (In Dutch).
30. Development Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna: 2008. Available at (last accessed 7 October 2010).
31. Bates D, Maechler M, Dai B. lme4: Linear mixed-effects models using S4 classes. R package version 0.999375-28. 2008. Available at (last accessed 7 October 2010).
32. Ray WA, Thapa PB, Gideon P. Misclassification of current benzodiazepine exposure by use of a single baseline measurement and its effects upon studies of injuries. Pharmacoepidemiol Drug Saf 2002; 11: 663-9.
33. Ziere G, Dieleman JP, van der Cammen TJ, Stricker BH. Association between SSRI use and fractures and the effect of confounding by indication. Arch Intern Med 2007; 167: 2369-70.
34. Whooley MA, Kip KE, Cauley JA, Ensrud KE, Nevitt MC, Browner WS. Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med 1999; 159: 484-90.
35. Davies SJ, Eayrs S, Pratt P, Lennard MS. Potential for drug interactions involving cytochromes P450 2D6 and 3A4 on general adult and functional elderly psychiatric wards. Br J Clin Pharmacol 2004; 57: 464-72.
36. CBO, Dutch Institute for Healthcare Improvement. Guideline for Diagnostics and Drug Treatment of Dementia. Alphen aan den Rijn: Van Zuiden Communications BV, 2005. (In Dutch).
37. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308-14.
38. Wood S, Cummings JL, Hsu MA, Barclay T, Wheatley MV, Yarema KT, Schnelle JF. The use of the Neuropsychiatric Inventory in nursing home residents. Characterization and measurement. Am J Geriatr Psychiatry 2000; 8: 75-83.
39. Zuidema SU, Derksen E, Verhey FRJ, Koopmans RTCM. Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. Int J Geriatr Psychiatry 2007; 22: 632-8.
40. Zuidema SU, de Jonghe JFM, Verhey FRJ, Koopmans RTCM. Predictors of neuropsychiatric symptoms in nursing home patients: influence of gender and dementia severity. Int J Geriatr Psychiatry 2009; 24: 1079-86.
41. Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry 2010; 71: 1259-72.
42. Vestergaard P, Rejnmark L, Mosekilde L. Anxiolytics, sedatives, antidepressants, neuroleptics and the risk of fracture. Osteoporos Int 2006; 17: 807-16.
43. Hansen RA, Moore CG, Dusetzina SB, Leinwand BI, Gartlehner G, Gaynes BN. Controlling for drug dose in systematic review and meta-analysis: a case study of the effect of antidepressant dose. Med Decis Making 2009; 29: 91-103.
44. Bains J, Birks JS, Dening TR. The efficacy of antidepressants in the treatment of depression in dementia. Cochrane Database Syst Rev 2009; (4): CD003944.