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Benzodiazepines, Antidepressants Linked To Increased Risk Of Falls And Fractures In Older Adults

Marilyn Folk BScN medical reviewer
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: April 3, 2019

Benzodiazepines, Antidepressants Linked To Increased Risk Of Falls And Fractures In Older Adults

Numerous studies have found a link between psychotropic drugs, such as benzodiazepines and antidepressants, with an increased risk of falls and fractures in older adults (65 and older).[1][2][3][4][5]

A recent study has confirmed this link albeit with some questions. Researchers found that, “compared with those older adults who were not prescribed an antidepressant, incident antidepressant users had a higher risk of hip fracture at all points during the year before and after taking the antidepressant, with the period of the most elevated risk at 30 to 16 days before an antidepressant was administered.”[6]

There is, however, some discussion about direct cause as the researchers thought other factors could be at play.[7] Nevertheless, they found “during the postfracture period, rightly or wrongly, antidepressants are prescribed at a high rate.”

What is further troubling is that even though this increased risk is well understood by primary care clinicians and psychiatrists, the use of these drugs continues to rise among older adults. This is particularly troubling because falls and fractures can lead to premature death in the elderly. Increasing the likelihood of falling due to these types of psychotropic medications seems like an unnecessary risk especially since taking these medications could precipitate an early death among those over 65 years of age.

Therefore, caution is advised. If you have an elderly loved one who is taking a benzodiazepine or antidepressant medication, you may want to talk with him/her and their doctor to see if discontinuation is appropriate. At the very least, close monitoring is essential.

REFERENCES:

1. de Jong, Marlies R, et al. “Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies.” Therapeutic Advances in Drug Safety, 4 Aug. 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125318/

2. Donnelly, Karen, et al. “Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis.” PLOS One, 27 April 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407557/

3. Vries, de, et al. “Elimination Half-Life of Benzodiazepines and Fall Risk: Two Prospective Observational Studies.” OUP Academic, Oxford University Press, 30 July 2013, academic.oup.com/ageing/article/42/6/764/46902.

4. “The Association between Medications and Fall Risk.” CPSA, 8 Jan. 2016, www.cpsa.ca/the-association-between-medications-and-fall-risk/.

5. Mayor, Susan. “Antidepressants and Benzodiazepines Are Linked to Hip Fracture in Elderly People, Finds Study.” The BMJ, British Medical Journal Publishing Group, 9 Mar. 2017, www.bmj.com/content/356/bmj.j1237.

6. Iaboni, Andrea. “A Status Update on the Association Between Antidepressants and Fractures: Breaking Up?” JAMA, American Medical Association, 2 Jan. 2019, jamanetwork.com/journals/jamapsychiatry/fullarticle/2719272...

7. “Antidepressants Tied to Hip Fracture Risk in Older Patients.” Medscape Log In, 2 Jan. 2019, www.medscape.com/viewarticle/907165...


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