It is estimated that one in four older adults experiences a fall each year, which can often result in serious injuries. To mitigate the risk of falls among seniors, regular medication reviews are necessary as many commonly prescribed drugs are associated with an increase in fall risk.
The purpose of having such medication reviews is to help seniors work with their healthcare providers to reduce or eliminate the use of drugs that can increase the risk of falls.
Geriatricians have highlighted certain medications that should be reduced or stopped altogether for seniors that are susceptible to falls. They have identified and grouped 10 common medications that cause falls in seniors and divided them into 3 broad categories of drugs.
The 3 Categories & Types Of Medications That Can Cause Falls In Seniors
Below we have provided summarized information that explains how these top medications affect fall risk, and what to do if a senior takes any one or more of these medications.
Friendly reminder - Medication changes should only be done by a healthcare professional or family doctor.
Category 1 - Medications Affecting Brain Function
This class of medication is known as psychoactive or psychotropic drugs. They affect brain function and tend to cause drowsiness.
These medicines can also cause confusion, especially in adults with dementia or memory problems.
- Benzodiazepines
They are prescribed to help with anxiety or to help people sleep.
Suddenly stopping the use of benzodiazepines can be dangerous. Their use should be reduced slowly under medical supervision.
Common drugs include Ativan, Valium, Restoril, and Xanax. Their generic names are lorazepam, diazepam, temazepam, and alprazolam.
- Non-benzodiazepine Prescription Sedatives
They are prescribed to treat insomnia and sleep problems
Common drugs include Ambien, Sonata, and Lunesta. Their generic names are zolpidem, zaleplon, and eszopiclone
- Antipsychotics
Antipsychotics are prescribed to control difficult behaviours in Alzhiemer’s/dementia or any other form of cognitive impairment.
Sometimes this type of psychotropic medication is also administered to people with depression.
Typical antipsychotics are mainly second-generation, including Risperdal, Seroquel, Zyprexa, and Abilify (generic names: risperidone, quetiapine, olanzapine, and aripiprazole).
- Anticonvulsants (seizure medications) And Mood Stabilizers
Seizure medications include Depakote and Neurontin.
Depakote (valproic acid) is a mood stabilizer that is sometimes used to manage complex behaviours in medical conditions such as Alzheimer’s or other dementias.
Neurontin (gabapentin) is another seizure medication often used to treat nerve pain.
- Antidepressants
Antidepressants are administered to treat mental health conditions such as depression or anxiety.
Zoloft, Celexa, Lexapro, Paxil, Prozac, Remeron, Wellbutrin, and Effexor are some of the most common antidepressants. Their generic names are sertraline, citalopram, escitalopram, paroxetine, fluoxetine, mirtazapine, bupropion, and venlafaxine)
Tricyclic antidepressants like Elavil and Pamelor (amitriptyline and nortriptyline) are anticholinergic so they’re not used for depression, but are sometimes used to manage nerve pain.
- Opioid (narcotic) Pain Relievers
Opioids include:
- Codeine
- Hydrocodone
- Oxycodone
- Morphine
- Fentanyl
- Methadone
Their known adverse drug reactions include drowsiness, nausea and slow breathing.
Research investigating links between falls and opioids had no conclusive evidence, but experts recommend that they should be reviewed when working to reduce fall risk.
- Anticholinergics
Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions
Many over-the-counter drugs, sleeping aids and prescription drugs are anticholinergic.
These drugs include:
- Antihistamines like Benadryl,
- “PM” versions of over-the-counter pain relievers (Nyquil, Tylenol PM)
- Overactive bladder medications like Ditropan and Detrol
- Medications for vertigo, motion sickness, or nausea like Dramamine, Antivert, Scopace, and Phenergan
- Anti-itch meds like Vistaril (hydroxyzine)
- Muscle relaxants like Flexeril (cyclobenzaprine)
- Tricyclic antidepressants and Paxil
Although research has shown no conclusive findings, these drugs can cause drowsiness and increase fall risk.
Category 2 - Medications That Affect Blood Pressure
Taking low or high blood pressure medications can sometimes cause a sudden change in blood pressure. A drop in blood pressure increases the risk of falls as it makes the individual feel dizzy or faint.
Postural hypotension or orthostatic hypotension is the sudden drop in blood pressure upon standing up. Most medications for high blood pressure can cause or worsen postural hypotension.
Medications such as tamsulosin (brand name Flomax) and other similar medications to improve urination can also cause postural hypotension.
- Antihypertensives
Antihypertensives are prescribed to treat high blood pressure and they are recommended for review by geriatricians and other experts when working to reduce the risk of falls.
- Other Medications That Affect Blood Pressure
Other medications for high blood pressure include Flomax, Hytrin, Cardura, and Minipress (tamsulosin, terazosin, doxazosin, and prazosin).
Category 3 - Medications That Lower Blood Sugar
Seniors with diabetes are required to use medication to lower blood sugar. However sudden drops in blood sugar can increase the risk of falls.
Common drugs for lowering blood sugar are:
- Sulfonylureas
- Biguanides/Metformin
- Alpha-glucosidase inhibitors
- Thiazolidinediones
- Meglitinides
Adverse effects of common diabetes drugs include worsening hypoglycemia, upset stomach and diarrhea.
Reviewing Prescribed Medications For Seniors
Suddenly discontinuing a drug could cause serious harm. As such, if a certain drug is associated with increased fall risk, it doesn’t always mean that seniors should stop using it.
In some cases, healthcare professionals may reduce the medication intake of certain drugs to the lowest effective dose possible in order to help curtail the risk of fall-related side effects.
Other Ways Of Reducing The Risk Of Falls
Use A Medication Dispenser
The importance of medication management for seniors who take any of the above medications cannot be overstated. Knowing what medication is for what purpose and what possible side effects it could have is essential when it comes to reducing the risk of falls in seniors.
To help make medication management safer, easier, and more secure use an automatic medication dispenser such as the one offered by Northwood Intouch.
A medication dispenser ensures that drugs are taken on time and in the right quantity, with or without supervision.
Use An Automatic Fall Detection Device
If a loved one is prone to falling or has a history of falls it is also highly recommended to invest in an automatic fall detection unit.
This is because no matter how many precautions we take, falls can still happen. Such a device can, at the very least, ensure that in the event of a fall help arrives as soon as possible potentially reducing both physical and mental pain.
For more information on how to keep seniors safe, healthy, and active, all year round, visit Northwood Intouch or give us a call at (902)-492-3346 or 1-800-461-3346.
