Psychotropic medication withdrawal and a home-based exercise program to prevent falls: A randomized, controlled trial

OBJECTIVE: To assess the effectiveness of psychotropic medication withdrawa l and a home-based exercise program in reducing falls in older people. DESIGN: A randomized controlled trial with a two by two factorial design. SETTING: Seventeen general practices in Dunedin, New Zealand. PARTICIPANTS: Women and men aged 65 years registered with a general practit ioner and currently taking psychotropic medication (n = 93). INTERVENTIONS: Two interventions: (1) gradual withdrawal of psychotropic me dication versus continuing to take psychotropic medication (double blind) a nd (2) a home-based exercise program versus no exercise program (single bli nd). MEASUREMENTS: Number of falls and falls risk during 44 weeks of follow-up. Analysis was on an intent to treat basis. RESULTS: After 44 weeks, the relative hazard for falls in the medication wi thdrawal group compared with the group taking their original medication was .34 (95% CI, .16-.74). The risk of falling for the exercise program group compared with those not receiving the exercise program was not significantl y reduced. CONCLUSIONS: Withdrawal of psychotropic medication significantly reduced th e risk of falling, but permanent withdrawal is very difficult to achieve.