Researchers reviewed medication studies published between 1996 and 2007 with the goal of updating information about medications associated with increased fall risk.

Falls are one of the leading causes of death in older people, and the possibility of falling is significantly increased by vestibular dysfunction. This meta-analysis on nine classes of drugs incorporated results of 22 studies that in total included nearly 80,000 people aged 60 and older.

Three drug classes were found to significantly increase fall risk: sedatives and hypnotics (usually sleeping pills); antidepressants; and benzodiazepines, including tranquilizers such as alprazolam (Xanax) and diazepam (Valium). Increased fall risk also occurred with antipsychotics and nonsteroidal antiinflammatory drugs such as aspirin; however, the researchers noted that assessing these drugs is complicated by their use in treating conditions that are themselves associated with an elevated fall risk.

Narcotics were not associated with fall risk, although this finding may be a result of limitations imposed by the relatively small number of studies for most drug classes reviewed and the differences among how the studies focused on falls as a measured outcome.

Regardless, the findings suggest that those already at risk for falling, which includes patients with vestibular disorders, should carefully review any prescriptions in the three most problematic classes with their doctors.

-Woolcott JC et al. Arch Intern Med
2009; 169:1952-1960