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Antidepressant use and orthostatic hypotension in older adults living with mild‐to‐moderate Alzheimer disease

International Journal of Geriatric Psychiatry Aug 07, 2020

Dyer AH, Murphy C, Briggs R, et al. - Researchers conducted a cross‐sectional analysis to explore the connection between antidepressant use and the presence of orthostatic hypotension (OH). OH is defined as a drop of ≥ 20 mmHg systolic BP (SBP)/≥ 10 mmHg diastolic BP (DBP), at 1 minute (classical OH) and 5 minutes (delayed OH). Candidates with mild‐moderate AD were selected from 23 centres in nine countries using baseline data from the NILVAD study, a randomised controlled trial of the antihypertensive Nilvadipine in mild‐to‐moderate Alzheimer Disease (AD). Two‐fifths of the of the 509 candidates (39.1%; 199/509) were prescribed a regular antidepressant. A significantly greater reduction in SBP/DBP at 5 minutes was seen in older adults with AD using antidepressants. Specifically, the use of selective serotonin reuptake inhibitor may be a risk factor for OH. To minimize the risk of falls in this vulnerable cohort, clinicians need to screen older antidepressant users, especially those with AD, for ongoing orthostatic symptoms.

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