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GoodRx Health9 Types of Medications That Can Make Falls More Likely in Older Adults

Medication-Induced Fall Risk in Older Adults: A Comprehensive Review of Contributing Drugs

As the elderly population grows, the incidence of falls and related complications also increases, highlighting the importance of medication management in this demographic. A detailed review of the types of medications associated with an increased risk of falls reveals that certain drug classes commonly prescribed to older adults significantly contribute to balance issues and subsequent fall risks. For physicians, understanding these risks is critical to optimizing patient care and minimizing preventable harm.

Key Points:

  1. Antidepressants: Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are linked to higher fall risks among older adults. Amitriptyline and sertraline are examples where caution is advised.
  2. Sleep Medications: Drugs like zolpidem and eszopiclone, used for insomnia, can increase fall likelihood. Behavioral therapy is recommended as a safer alternative.
  3. Anti-Anxiety Medications: Benzodiazepines such as lorazepam and diazepam are associated with an increased risk, particularly with long-term use.
  4. Muscle Relaxants: Medications like methocarbamol and cyclobenzaprine may induce drowsiness and confusion.
  5. Anti-Seizure Medications: Commonly causing dizziness and confusion, drugs like carbamazepine and gabapentin are significant contributors to falls in the elderly.
  6. Antipsychotics: Medications like haloperidol and fluphenazine can lead to sedation and blurred vision, which may contribute to instability.
  7. Pain Medications: Opioids such as oxycodone and hydrocodone increase fall risk due to their side effects, including drowsiness and slowed motor skills.
  8. Blood Pressure Medications: Various antihypertensives can destabilize blood pressure levels, enhancing the likelihood of a spill, especially with dose changes.
  9. Antihistamines: Older-generation antihistamines, like diphenhydramine, cause side effects such as sleepiness and blurred vision.

More than 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture. At least 300,000 older people are hospitalized for hip fractures. (CDC)

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