Antidepressants and Falls: How Mood Medications Increase Fall Risk and What to Do

When you take antidepressants, medications used to treat depression, anxiety, and other mood disorders. Also known as antidepressant drugs, they help balance brain chemicals—but they can also make you unsteady on your feet. It’s not just about feeling tired. Many common antidepressants cause orthostatic hypotension, a sudden drop in blood pressure when standing up, which leads to lightheadedness, blurred vision, and yes—falls. This isn’t rare. Studies show older adults on antidepressants are up to 40% more likely to fall than those not taking them. And falls aren’t just scary—they can break hips, cause brain injuries, and lead to long-term disability.

Not all antidepressants carry the same risk. tricyclic antidepressants, older types like amitriptyline and nortriptyline are the biggest culprits because they block multiple brain receptors, including those that control blood pressure. Even some SSRIs, like sertraline and fluoxetine, can cause dizziness, especially when you first start or change doses. The problem gets worse when you take more than one medication. If you’re also on blood pressure pills, sleeping aids, or pain meds, the combo can turn a simple stand-up into a trip to the ER. The good news? You don’t have to live with this risk. Your doctor can switch you to a lower-risk option like bupropion (Wellbutrin), which rarely causes dizziness, or adjust your dose. Simple changes—like standing up slowly, drinking more water, and avoiding alcohol—can cut your fall risk in half.

It’s not just about the drug—it’s about your body’s response. As you age, your blood vessels don’t tighten as fast, your kidneys process drugs slower, and your balance systems weaken. That’s why a dose that was fine at 50 might be dangerous at 70. If you’ve had even one close call—feeling faint when getting out of bed, stumbling on stairs, or needing help after standing—talk to your doctor. Don’t wait for a fall to happen. Review every pill you take, not just the antidepressant. And if you’re caring for an older relative, watch for signs: slow movements, avoiding stairs, or suddenly refusing to walk alone. These aren’t just signs of aging—they might be signs your meds need adjusting.

Below, you’ll find real, practical guides from people who’ve been there—how to spot the warning signs, which antidepressants are safest for seniors, how to reduce dizziness without quitting meds, and what to do if you’ve already fallen. This isn’t theory. It’s what works in real life.