Grandma’s been feeling real blue since her dearly beloved passed away.

Life has lost its lustre…

Tuesday night bingo doesn’t hit the way it used to…

There’s no getting around it. She’s depressed.

You do the obvious things. Talking therapy, CBT and a prescription of sertraline for the road. The problem is, now she’s falling…and she can’t get up. Thank God for the Life Alert.

You’ve got a real problem on your hands; why is this poor woman falling over?

A recent study published in the says that SSRI you’ve given her could be linked with an increase in postural hypotension.

The aim of the study was to examine if the risk of postural hypotension–a fall in BP from seated position of 20 mmHg/10mmHg– was associated with antidepressant use in over 60’s in UK primary care.

This demographic is often neglected due to older adults being excluded from clinical trials.

Researchers looked at over 41,000 patients aged 60+ in UK primary care, all of whom had a diagnosis of PH and were prescribed one of the big three antidepressant categories between 2000 and 2018.

Those antidepressants were SSRI(22%), TCA’s(20%) and ‘others’ like SNRI’s (11%)

They used a self-controlled case series design… which basically means each person acts as their own control. It’s like: “how dizzy were you before sertraline vs. after?” Four exposure risk periods were analysed

90-days pre-treatment.

Day 1-28 post-treatment.
Day 29-56 post-treatment
Over 57 days

With this information they used statistical analysis to estimate Incident rate ratios(IRR’s) for each of the risk periods.

From this study they found:

For all classes of antidepressant there was a significant increased risk of PH in Day 1-28 of drug exposure, which reduced thereafter.

SSRIs had the highest IRR of 4.22. That’s a 4-fold increased risk of postural hypotension.

TCAs had an IRR of 2.12 in Day 1-28. The ‘others’ group an IRR 2.17

So yes. The medication may have given her her mojo back, but that falls risk is no joke. Pretty easy fix though. Keep an extra keen eye on over 60’s for a month after a depression prescription. Check their blood pressure, and ask if they've found themselves spending quality time with the floor.

After 28 days, they should be alright. Mentally lifted. Physically upright.