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Elderly at Higher Risk for Falls After Antidepressant Drug Changes
Written by George Tait
Monday, 25 July 2011 10:56
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McKnight's Long-Term Care News & Assisted Living recently published an article titled Falling Risk for Residents Increases After Antidepressant Changes stating that nursing home residents have a five-fold increased risk of falling in the two days immediately following a change in the dosage of certain antidepressants. Specifically, non-SSRI (selective serotonin reuptake inhibitors) antidepressants such as Wellbutrin and Effexor, appear to increase the risk of falling. The article states,
The study's lead author, Sarah D. Berry, M.D. found that the risk of falling was much higher within two days of a change in a non-SSRI prescription. Berry suggests that "nursing home staff should keep a watchful eye on residents in the days following a non-SSRI antidepressant change to prevent falls and clinicians should avoid making changes on weekends or during times when unfamiliar staff is present." The study was published in The Journals of Gerontology titled Antidepressant Prescriptions: An Acute Window for Falls in the Nursing Home concluding:
Continuity of care is defined by the American Academy of Family Physicians as:
When physicians make changes to a resident's drug regimen they need to make sure that those changes are made during weekdays. Changes should be made during weekdays because typically that is when there are more staff in the facility and those staff are most familiar with the resident. The staff employed over the weekend are often part-time staff that are not as familiar with the resident and are not as keen to notice behavioral changes in the resident. When elderly residents are first admitted to nursing homes they are obviously taken out of their own environment and are often confused. If the resident is at risk for falls already the potential for falls is compounded with changes to their pharmaceutical regimen. Physicians and staff need first to make these changes during the week and furthermore put into place appropriate and proactive measures to keep the resident safe from harm. The harm resulting from a fall to the elderly causes them pain and grief. When an elderly and beloved falls in a nursing home the family also experiences emotional trauma. The failure of the physician and the facility to properly protect residents sometimes rises to the level of medical malpractice.
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