Drugs & Aging

, Volume 30, Issue 12, pp 1039–1039

Comment on: The Effects of Fall-Risk-Increasing Drugs on Postural Control: A Literature Review

Open Access
Letter to the Editor

de Groot et al. [1] reported that an increased fall risk from the use of psychotropic drugs was associated with impairments in postural control, which these drugs could induce [1]. The effects seem to be more pronounced when the half-life is longer [1]. Hangover effects on postural control (after 8 h of administration) were found mainly for benzodiazepines with an intermittent or long half-life [1]. However, some factors, except for hangover effects and nightly effects, such as the strength of the preparation and muscle-relaxant effects, affect fall risk. Psychotropic drugs with a short half-life may be likely to confuse patients, increasing fall risk. In fact, one meta-analysis showed that the pooled odds ratio for one or more falls in older people was 1.44 (95 % confidence interval [CI] 1.09–1.90) for short-acting benzodiazepines and 1.32 (95 % CI 0.98–1.77) for long-acting benzodiazepines [2]. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel reported that shorter-acting benzodiazepines were not safer than long-acting ones [3]. Are psychotropic drugs with longer half-lives more likely to increase fall risk than psychotropic drugs with shorter half-lives?

Notes

Acknowledgments

Dr Toda has no conflicts of interest to declare. No sources of funding were used for the preparation of this letter.

References

  1. 1.
    de Groot MH, van Campen JP, Moek MA, Tulner LR, Beijnen JH, Lamoth CJ. The effects of fall-risk-increasing drugs on postural control: a literature review. Drugs Aging. Epub 5 Sep 2013. doi:10.1007/s40266-013-0113-9.
  2. 2.
    Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc. 1999;47(1):30–9.PubMedGoogle Scholar
  3. 3.
    American Geriatrics Society 2012 Beers Criteria Update Expert Panel: American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616–31.Google Scholar

Copyright information

© The Author(s) 2013

Open AccessThis article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

Authors and Affiliations

  1. 1.Department of RehabilitationHatsukaichi Memorial HospitalHatsukaichiJapan

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