What Causes Falls? Let’s Look At Your Medications

By August 30, 2017Fall Prevention

Medications are often a necessary evil. They can improve your quality of life, reduce your pain, and decrease your risk of developing life threatening emergencies. On the flip side, some medications have the potential for undesirable side effects. Let’s take a look at medications which can impact your balance and increase your risk for falls.

  • Antihypertensives are medications which are used to treat high blood pressure.
  • One of the primary concerns with certain blood pressure medications is orthostatic hypotension—a sudden drop in blood pressure as you rise from a lying or seated position to a standing position. This drop in blood pressure can lead to lightheadedness, loss of consciousness, and falls.
  • Studies evaluating the impact of antihypertensive medications on falls have yielded mixed results. Some demonstrate only a weak association, whereas others show a significantly increased risk of falls, along with a greater chance of sustaining a serious injury during a fall.
  • Diuretics are commonly used for leg swelling, high blood pressure, and heart failure.
  • Long term use of these medications has been associated with a small increase in your risk of falling.
  • It appears that you may be most vulnerable during the first 24 hours after starting diuretic.
  • Antidepressants and neuroleptics are commonly used to manage mental illness including depression, anxiety, and schizophrenia.
  • SSRIs and TCAs are common antidepressants which can increase your risk of falling by 1.8 to 2-fold. With SSRIs, this appears to be related to impaired balance and sleep disturbance, whereas TCAs are associated with sedation, orthostatic hypotension, and abnormal heartbeats.
  • Antipsychotic medications used to treat schizophrenia can increase your fall risk by 1.75-fold.
  • Benzodiazepines are used to treat anxiety disorders and may also be used as a sleep aid in those with insomnia.
  • This group of medications carries the highest risk for falls. Studies have shown that these medications increase your risk of falls leading to painful injuries by 2.2-fold, and increase the risk of hip fracture by 50-110% in the elderly.
  • Long term use of benzodiazepines has also been linked to depressed mood, impaired cognition, and loss of physical function.
Nonsteroidal anti-inflammatories (NSAIDs)
  • Nonsteroidal anti-inflammatories are the only over-the-counter medication to make the list. These are used by 10-30% of older adults on a regular basis to treat pain and inflammation.
  • Several studies have linked NSAIDs to a mildly increased risk of falls, though the reasoning behind this association is not clear.

You should discuss medication side effects with your medical provider, and make changes to your medications if needed.


  • Gael Geniesse says:

    I had a prolia shot and am scheduled for another one in February. I’m concerned because I’ve read where osteoporosis drugs can make bones denser – but actually make them weaker. If this is true – is it the same for the Prolia shot? What are the side effects of the prolia?

    • OsteoAdvisor says:

      Hi Gael,

      There is a complete list of Prolia’s possible side effects under the medication section of the website. Unfortunately, there are many misconceptions and and plenty of misinformation about osteoporosis medications available on the internet. The simple answer is this– Prolia has been shown to INCREASE bone density, and at the same time, DECREASE your risk of breaking bones. It wouldn’t make sense to give a medication that would weaken your bones and make them more likely to break…

      There are 2 risks that we need to consider when it comes to osteoporosis.
      #1: What happens if you choose not to take the medication? Your risk of broken bones is high, and osteoporosis medications are the only research proven way to decrease your risk of breaking bones. Women have somewhere between a 33% and 50% lifetime risk of breaking bones from osteoporosis, which is very high.

      #2: What is the real risk of side effects from osteoporosis medications? As with any medication, there is a chance for side effects. The one that sounds scary– atypical femur fractures (or a “stress fracture” of the femur bone) has been reported in some people that take osteoporosis medications (including prolia, fosamax, etc.) for a long period of time. This is the side effect that some websites will use to try to justify osteoporosis medications “weakening” bones… which is inaccurate. While it sounds scary, the risk of this side effect is INCREDIBLY rare. When you compare the statistics, you are more likely to get struck by lightning in your lifetime than to develop this side effect. Prolia has been shown to decrease your risk of breaking bones by 50+%, which is great!

      So in the end, it always comes down to a risk/benefit decision. Your odds of breaking bones are high, the odds that Prolia prevents a broken bone is relatively high, your risk of side effects from Prolia is low.

      In the end, it is your body and you have to decide what is best for you. I aim to provide you with unbiased facts to help you support your decision. I have a series of articles that I will post on this topic in the future, because it is certainly a concern for many people.

      Feel free to send me a message if you have any questions.