Frailty is characterised by weakening of body’s normal functioning and can cause unwanted health problems such as hospitalisation, falls, sensitivity to unwanted effects of medications and death. Frailty can significantly increase the health-care costs and is a global health concern, and its incidence is expected to rise due to the rapid increase in ageing population.
Depression is one of the most common mental health illnesses worldwide and can have significant negative effect on the quality of life of patients and their care givers and cause death mainly due to suicide.
Depression is treated mostly in primary care settings such as GP surgeries in the UK. A group of medications called Selective Serotonin Reuptake Inhibitors (SSRIs) are the first line antidepressant drugs for treatment of depression in adults in the UK. They can cause unwanted effects such as falls, irregular heartbeat, anxiety, weakness of bones, nausea and feeling sick, bleeding, and sexual problems. They can also interact with other medications.
Frail patients generally have higher possibility of being diagnosed with depression. Frail patients may respond less favourably to the antidepressants and are more sensitive to their unwanted effects. Many frail patients have other illnesses and therefore are often on numerous medications which can interact with antidepressants and induce further risks and complications.
There is a significant gap of knowledge in relation to the role of SSRIs in causing or worsening frailty. The current treatment guidelines for treatment of depression do not provide sufficient advice about risks and benefits of using SSRIs for treatment of depression in frail patients.
This research investigates whether the use of SSRIs for treatment of depression can cause or worsen frailty in primary care patients. It also investigates the risks and benefits of using SSRIs as the first line antidepressants for treatment of depression in frail primary care patients and possible links between genetic and patient characteristics and responding to the SSRIs or having unwanted effects.
This project aims to develop a screening tool to help clinicians to prescribe SSRIs for frail patients when are expected to be effective and less likely to cause unwanted side effects to reduce the harm to patients and ensure effective treatment and is expected to last 36 months.
