Stopping psychotropic medications can reduce falls and improve cognition

van der Cammen TJ, Rajkumar C, Onder G, et al. Drug cessation in complex older adults: time for action. Age Ageing. 2014;43:20-5.

Review question

In older adults who have a history of falls, cognitive impairment or delirium, can stopping certain medications reduce these health problems?

Background

Many older people have more than one health problem, and they may take several different medications at the same time. Some medications, or interactions between different medications, can cause falls or confusion. People who are prone to falls or confusion are more likely to be affected by medicines that can cause falls or confusion. In some cases, it might be better for a person to stop taking a medication to stop these side effects.

How the review was done

The researchers did a systematic review, searching for studies up to May 2013. The key features of the studies were:

• people were 65 years of age or older and had experienced falls, cognitive impairment, or delirium; and
• the studies looked at the effect of stopping use of certain medications.

What the researchers found

Stopping psychotropic medications reduced the rate of falls.

Regular medication reviews by family doctors reduced the risk of falls.

Stopping psychotropic medications improved cognition.

No studies looked at the effect of stopping drugs on delirium.

Conclusion

In older people who have a history of falls or cognitive impairment, stopping psychotropic medications and regular medication reviews by family doctors reduce these health problems.

Stopping medications to reduce falls, cognitive impairment or delirium