Psychotropic Drugs and Polypharmacy are Proven Risk Factors for Falls
Tawfic Nessim Abu-Zahra, MSc
Many risk factors have been shown to contribute to falls suffered by the elderly, including the use of sedatives1 and the concurrent use of several medications.2-4 Evidence-based conclusions concerning the relationship between drugs and falls provide limited confirmation due to the studies results' variability, inconsistencies in classification schemes of drugs, and because of the small number of subjects participating in most studies.3 Thus, singling out specific agents and recommending guidelines for prescribing to the elderly is difficult. However, some studies have implicated psychotropic or CNS-active drugs, including sedatives, antidepressants and neuroleptics, as being especially high-risk in terms of leading to falls. Hence, special caution should be taken in prescribing these for the elderly.
Leipzig and colleagues reviewed3,4 all existing literature dealing with the association between drugs and falling in the elderly. Pooled odds ratios that measure the likelihood that a person taking a drug will also experience a fall were calculated for different classes of drugs.