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Elderly Who Stop Certain Drugs May Cut Risk of Falls

Tilt-table tests improve after removal of cardiovascular and psychotropic drugs

WEDNESDAY, May 16 (HealthDay News) -- Withdrawal of fall-inducing psychotropic and cardiovascular drugs can help improve tilt-table test results in older patients, researchers report in the May issue of the Journal of the American Geriatrics Society.

Tischa van der Cammen, M.D., Ph.D., of Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues conducted a prospective study of 211 new patients at a geriatric outpatient clinic, to determine whether tilt-table test outcomes improved after removal of fall-risk-increasing drugs such as psychotropic drugs (antidepressants, antipsychotics, sedatives) and cardiovascular drugs (diuretics, type Ia antiarrhythmics, digoxin). The test measured carotid sinus hypersensitivity, orthostatic hypertension and vasovagal collapse.

Removing or reducing the dose of fall-risk-increasing drugs for one month was found to reduce the risk of poor outcomes on the tilt-table test by up to 73 percent. When considering only the subgroup of cardiovascular fall-risk-increasing drugs, removal improved tests by 87 percent for carotid sinus hypersensitivity.

"Because the association between these cardiovascular improvements and non-occurrence of falls was significant, it is likely that part of the fall-risk-increasing drug-related falls in this cohort were mediated through cardiovascular side effects," the authors write. "Therefore, in individual patients, repeated tilt-table testing can be a useful tool to measure the effect of the intervention."

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