Selective serotonin reuptake inhibitors (SSRIs) could pose a higher health risk to the elderly than some older types of antidepressants, a study by the Universities of Nottingham and East Anglia has found.

Elderly patients on SSRIs had a higher risk of dying within the next year than those on tricyclic antidepressants (TCAs), the study of more than 60,000 patients found.

The study, published by the BMJ, looked at 60,476 patients who were over 65 and suffered from newly diagnosed depression. Half of the patients received prescriptions for SSRIs, one third for TCAs and 13.5 per cent were prescribed other antidepressants.

Patients on SSRIs had a 10.6 per cent risk of dying within the next year and the medicines were also associated with all-cause mortality, stroke, falls, fracture, epilepsy, seizures and hyponatraemia more strongly than TCAs.

Patients on TCAs had an 8.1 per cent risk of dying within the next year, while the risk rose to 11.4 per cent for the other antidepressants. Patients not taking antidepressants had a 7.5 per cent risk of dying some time in the next year.

Patients were at highest risk during the first 28 days of starting an antidepressant and the first 28 days after stopping. When it came to individual drugs, trazadone, mirtazapine and venlafaxine were associated with some of the highest risks.

The study had "clear implications for more informed prescribing and enhanced clinical monitoring", said Ian Hickie, executive director of the University of Sydney's brain and mind research institute, in an accompanying editorial.

"Given the potential harms, the decision to prescribe for an older person with depression should not be taken lightly," he said.

The study's authors stressed that patient differences may account for some of the findings, and that further research was needed to confirm the conclusions.