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

Abstract

Objective: To assess the effectiveness of psychotropic medication withdrawal 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 practitioner and currently taking psychotropic medication (n = 93).

Interventions: Two interventions: (1) gradual withdrawal of psychotropic medication versus continuing to take psychotropic medication (double blind) and (2) a home-based exercise program versus no exercise program (single blind).

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 withdrawal 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 significantly reduced.

Conclusions: Withdrawal of psychotropic medication significantly reduced the risk of falling, but permanent withdrawal is very difficult to achieve.