Does Sertraline increase the risk of falls? (3+ facts)

In this article, we will discuss falls associated with Sertraline, including an examination of how Sertraline can lead to falls and guidance on what to do if you encounter falls while taking Sertraline.

Does Sertraline increase the risk of falls?

Yes, Sertraline does increase the risk of falls. It is one of the most commonly reported side effects of Sertraline and other antidepressants among the elderly population (2,3). Although it is a common side effect, its occurrence depends on individual patient factors and does not affect everyone taking this medication.

Sertraline is frequently prescribed for managing mental health conditions such as depression, anxiety and obsessive-compulsive disorder (OCD) (4). While it is generally considered safe and effective, there have been concerns about its potential to cause falls in certain individuals.

Although dangerous, some people may experience falls when they stand up too quickly, or when they feel abruptly dizzy. Either way, this side effect gets better within a few weeks and is manageable.

What does research suggest?

Selective serotonin receptor inhibitors (SSRIs), including Sertraline, commonly lead to falls, affecting approximately 39.4% of individuals taking this medication (4).

A systematic review of medications as a risk factor for falls indicated that SSRIs carry a higher risk of falling compared to traditional antidepressants such as Tricyclic antidepressants (TCAs) (3).

Several studies examining the risk of falls associated with antidepressant medications have suggested that the risk of falls while on Sertraline and other SSRI medications may be attributed to dehydration and the cardiovascular depressant effects of these medications (1,2,6).

Additionally, a study on depression, antidepressants and fall risk has proposed that SSRI and TCA medications could potentially have a detrimental impact on bone mineral density, increasing the risk of hip fractures (6). While the evidence is inconclusive, the possibility of fractures could worsen the consequences of falls by raising the risk of fall-related injuries.

Why does Sertraline increase the risk of falls?

The precise cause of Sertraline-induced falls remains unclear, however, one possible explanation is related to how Sertraline works. Sertraline affects serotonin neurotransmitters in your brain (4).

Sertraline exerts its effects by increasing serotonin levels in the brain (4). Serotonin plays a role in centrally regulating blood pressure and its elevation may reduce cardiac output, potentially leading to a decrease in blood pressure resulting in Sertraline-induced postural hypotension and increasing the risk of falls (6).

Moreover, through this mechanism, Sertraline can induce dizziness in patients due to increased serotonin levels in the brain (6).

Additionally, Sertraline’s effect on the gastrointestinal tract can reduce an individual’s fluid intake, potentially causing dehydration, which contributes to both orthostatic hypotension and mobility-related risks of falls (6).

However, not everyone experiences falls while taking Sertraline. People are unique and they can respond differently to medications.

It is important to remember that if you do experience falls while taking Sertraline, you should immediately seek medical intervention. Your doctor will guide you on the best way to mitigate and manage this side effect.

What to do if Sertraline causes falls?

Sertraline-induced falls are extremely dangerous and life-threatening. There are a few things you can do to mitigate and manage falls, including:

  • Consult your healthcare provider – It is important to discuss falls with your doctor. Your doctor will give you appropriate solutions to manage and avoid this side effect. Your doctor may make dosage adjustments to your medication or switch you to a different medication with less likelihood of causing this side effect
  • Exercise caution – After taking Sertraline, you should avoid strenuous activities such as operating heavy machinery. You should exercise caution while taking this medication to avoid accidents.
  • Stay hydrated – Drinking enough water is important to avoid dehydration induced by Sertraline. This will also help you to maintain normal blood pressure and thus avoid falls.
  • Eating nutritious foods –  Eating food nutritious in Calcium and Vitamin D is essential to reduce the risk of fall-related injuries such as fractures.

Conclusion

In this article, we have discussed Sertraline-induced falls and how it occurs. We have also covered important steps one should take if this side effect occurs.

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References

1.-

Flint AJ, Iaboni A, Mulsant BH, Rothschild AJ, Whyte EM, Meyers BS. Effect of Sertraline on Risk of Falling in Older Adults with Psychotic Depression on Olanzapine: Results of a Randomized Placebo-Controlled Trial. The American Journal of Geriatric Psychiatry [Internet]. 2014 Apr [cited 2023 Sep 30];22(4):332–6. Available from: https://pubmed.ncbi.nlm.nih.gov/23642462

 

2.-

Gebara MA, Lipsey KL, Karp JF, Nash MC, Iaboni A, Lenze EJ. Cause or Effect? Selective Serotonin Reuptake Inhibitors and Falls in Older Adults: A Systematic Review. The American Journal of Geriatric Psychiatry [Internet]. 2015 Oct [cited 2023 Sep 30];23(10):1016–28. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442757/

 

3.-

Hartikainen S, Lonnroos E, Louhivuori K. Medication as a Risk Factor for Falls: Critical Systematic Review. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences [Internet]. 2007 Oct 1 [cited 2023 Sep 30];62(10):1172–81. Available from: https://academic.oup.com/biomedgerontology/article-abstract/62/10/1172/568433

 

4.-

Singh HK, Saadabadi A. Sertraline [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2023 Sep 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/

 

5.-

Haddad YK, Kakara R, Marcum ZA. A comparative analysis of selective serotonin reuptake inhibitors and fall risk in older adults. Journal of the American Geriatrics Society [Internet]. 2022 Feb 8 [cited 2023 Sep 30];70(5):1450–60. Available from: https://doi.org/10.1111/jgs.17686

 

6.-

Van Poelgeest EP, Pronk AC, Rhebergen D, van der Velde N. Depression, antidepressants and fall risk: therapeutic dilemmas—a clinical review. European Geriatric Medicine [Internet]. 2021 Mar 15 [cited 2023 Sep 30];12(3):585–96. Available from: https://pubmed.ncbi.nlm.nih.gov/33721264

 

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