FALLS AND FRACTURES IN NURSING-HOME PATIENTS RECEIVING PSYCHOTROPIC-DRUGS

Falls in 44 matched control patients (average age 87.1) were statistically compared to 38 patients (average age 85.3) who received scheduled or as needed (prn) single-agent psychotropics over a 6-month period. Prospective assessments of psychotropic drug therapy were made on a monthly basis, and data on falls and fractures were retrospectively gathered. Both scheduled and prn single-agent usage of benzodiazepine (BZ) hypnotics, and scheduled usage of BZ anxiolytics and thioridazine increased the incidence and episodes of falls over the frequency of falls found in the control group. Fractures were more prevalent in the treatment group over the 6-month period, but half the falls in the control group resulted in fractures. Longer-acting BZs, both prn and scheduled, resulted in a greater rate of falls than the shorter-acting BZs, but even the shorter-acting (SA) BZs givne on a scheduled basis more often than three times a week had a greater rate of falls than the control group. When not more than 3 SABZ doses per week were given, no falls were noted for the follow-up 6-month period. It appears that most single psychotropics, except the SABZs given no more than three times a week, haloperidol and desipramine, increase the risk of falls and fractures in a very old frail nursing home population.