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

Falls in 44 matched control patients (average age 87.1) were statistic ally 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 mo nthly basis, and data on falls and fractures were retrospectively gath ered. Both scheduled and prn single-agent usage of benzodiazepine (BZ) hypnotics, and scheduled usage of BZ anxiolytics and thioridazine inc reased the incidence and episodes of falls over the frequency of falls found in the control group. Fractures were more prevalent in the trea tment group over the 6-month period, but half the falls in the control group resulted in fractures. Longer-acting BZs, both prn and schedule d, resulted in a greater rate of falls than the shorter-acting BZs, bu t even the shorter-acting (SA) BZs givne on a scheduled basis more oft en than three times a week had a greater rate of falls than the contro l 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 sin gle psychotropics, except the SABZs given no more than three times a w eek, haloperidol and desipramine, increase the risk of falls and fract ures in a very old frail nursing home population.