Antidepressants, Antipsychotics, and Sedatives Linked to Falls in Elderly

We’ve long been following issues surrounding the administration of certain medications to the elderly, specifically <"">antidepressants, antipsychotics, and sedatives. Sometimes these medications are given for seemingly pointless reasons. On other occasions, these medications appear to be linked to falls and other accidents in the elderly.

Science Daily just reported that such accidents among the elderly are “significantly” linked with these drugs—sedatives to help patients sleep and drugs used to treat mood disorders—citing a study conducted by an expert in “pharmaceutical outcomes research” out of the University of British Columbia. The study was published in the November 23 issue of the Archives of Internal Medicine.

The study, said Science Daily, gives the most current quantitative proof of how some drug classes affect falls in seniors. Falling and related complications—hip fractures, for instance—are the fifth leading cause of death in the “developed” world. The study revealed the greatest statistical link between antidepressants and falling, likely because the older drugs in this class can have intense sedative effects, wrote Science Daily. Other medications linked to falls included antipsychotics/neuroleptics used to treat schizophrenia and psychosis as well as benzodiazepines, including Valium.

“These findings reinforce the need for judicious use of medications in elderly people at risk of falling,” said principal investigator Carlo Marra, a UBC associate professor of Pharmaceutical Sciences, quoted Science Daily. “Safer alternatives, such as counseling, shorter-term, or less-sedating therapies, may be more appropriate for certain conditions,” added Marra. Marra is Canada Research Chair in Pharmaceutical Outcomes in the Collaboration for Outcomes Research and Evaluation at the Faculty of Pharmaceutical Sciences; is a member of the Centre for Hip Health and Mobility, part of Vancouver Coastal Health Research Institute; and is a research scientist at the Centre for Health Evaluation and Outcome Sciences at Providence Health.

The study looked at nine drug classes, updating, expanding, and analyzing 22 international observational studies from 1996-2007 that investigated falls in people aged 60 and older. Data on over 79,000 participants and both prescription and over-the-counter (OTC) drugs were reviewed, said Science Daily. Narcotics/painkillers were among the classes reviewed and while not statistically linked to falls in seniors; Marra said further research is needed.

Drugs taken to reduce blood pressure—anti-hypertensives; beta-blockers—for cardiac cases; diuretics; and nonsteroidal anti-inflammatory medications—aspirin and ibuprofen, were reviewed. “Elderly people may be more sensitive to drugs’ effects and less efficient at metabolizing medications, leading to adverse events, which in turn lead to falls,” said Marra.

We recently wrote that the Chicago Tribune broke with an expose on how some powerful psychotropic drugs are given to nursing home residents in Illinois without consent and valid psychiatric diagnoses. Some have suffered from a variety of adverse responses that include, said the Tribune, “tremors, dangerous lethargy, and a higher risk of harmful falls or even death.” The Tribune said it found 1,200 violations affecting 2,900 patients since 2001, all involving pychotropics; however, it is believed that the figures are higher given the dearth of regular investigations. According to the Tribune, some sites only inspect once every 15 months, and generally only conduct spot checks.

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