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Antidepressants, opioids can more than double risk of falls

Older Australians starting antidepressants or opioids face more than double the risk of a fall or hip fracture, a new paper says.

For the study, published today in Australian Prescriber, the research team compared 8828 veterans with hip fractures with 35,310 people of the same age and gender, examining their medicine use in the previous six months.

The risk of hip fracture was higher for all five groups of drugs tested (antidepressants, opioids, antiepileptic drugs, benzodiazepines and antipsychotics).

The highest risk, more than double, was when selective serotonin reuptake inhibitors or opioids were started. The team said this risk remained high with ongoing use.

Co-lead author Professor Libby Roughead from the University of South Australia said combining any of the five medications increases the risk even further – up to five times when antidepressants and anxiety medicines are started together.

Roughead said: “We suggest to prescribers they consider whether patients really need some of their medicines anymore.

“For example, an SSRI antidepressant may no longer be required if a patient is fully recovered from depression. Similarly, it may be possible to stop an antipsychotic in someone with dementia.

“Doctors should try stopping one medicine at a time, reducing it slowly over weeks or months.”

The researchers added that risk of falling can be lowered by reducing medicine use, exercising more and using other interventions such as occupational therapy and podiatry.

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