美国波士顿的研究人员发现，新近开始服用某些非选择性血清素再摄取抑制剂（non-selective serotonin reuptake inhibitor），如bupropion or venlafaxine；或最近刚刚增加上述药物的服用剂量之老年人易跌伤。究其原因，可能与服用上述药物后老年人易出现认知、协调和运动能力受损，及体位性低血压等有关。研究人员观察后发现，在刚刚开始服用或增加上述药物剂量的前两天，老年人跌伤的概率较服药或剂量增加前提高了５倍。这一结果提示，医生们在开具此类药物时应充分考虑其副作用，并详细交待注意事项，特别是在用药的过程中应加强对老年人的监护，以防不测。更多资讯，请参阅原文：

Certain Antidepressants Linked to Falls in Nursing Homes

Closer monitoring of patients changing or starting a non-SSRI is advised, researchers say

TUESDAY, July 26 (HealthDay News) -- In the days after they start taking non-SSRI (selective serotonin reuptake inhibitor) antidepressants, such as bupropion or venlafaxine, nursing home residents are at significantly greater risk for falls, according to a new study.

Researchers found the increased risk for falls also applies to those who had a dosage increase of their current prescription.

"Our results identify the days following a new prescription or increased dose of a non-SSRI antidepressant as a window of time associated with a particularly high risk of falling among nursing home residents," said study author Dr. Sarah D. Berry, a scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston.

More closely monitoring these nursing home residents for two days after a change in these antidepressants could help prevent falls, the researchers said.

In conducting the study, recently published online in the Journal of Gerontology: Medical Sciences, researchers examined information on 1,181 nursing home residents who had fallen. Specifically, they compared changes in their antidepressant medication one week and two weeks before the fall.

The study found a fivefold increased risk of falls among residents within two days of a new prescription or an increased dose of a non-SSRI. The risk of falls diminished each day following the prescription change, they said.

Berry attributed this increased risk of falls to the following possible causes:

Serious cognitive or motor effects associated with non-SSRI antidepressants that have not yet been fully examined.

Postural hypotension, a dramatic decrease in blood pressure upon standing, associated with certain non-SSRIs, such as trazodone.

Sedation and coordination problems linked to certain non-SSRIs.

Newer drugs, including serotonin-norepinephrine reuptake inhibitors, may also be associated with risk of falls, the researchers noted.

However, Berry said, "these drugs are effective at treating the symptoms of depression, and many clinicians are reluctant to withhold their use based solely on a risk for falls."

Therefore, "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," Berry concluded in an institute news release.

More than one-third of the country's nearly 1.6 million nursing home residents take some type of antidepressant medication, the study authors pointed out.

SOURCE: Hebrew SeniorLife Institute for Aging Research, news release, July 15, 2011