Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial.
OBJECTIVE
To assess the effectiveness of psychotropic medication withdrawal and a home-based exercise program in reducing falls in older people.


METHODS
A randomized controlled trial with a two by two factorial design.


METHODS
Seventeen general practices in Dunedin, New Zealand.


METHODS
Women and men aged 65 years registered with a general practitioner and currently taking psychotropic medication (n = 93).


METHODS
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).


METHODS
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.
Dunedin School of Medicine, Otago Medical School, New Zealand.
A J
AJ
Campbell
M C
MC
Robertson
M M
MM
Gardner
R N
RN
Norton
D M
DM
Buchner
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000458:organization & administration*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D015397:Program Evaluation; D016016:Proportional Hazards Models; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D016037:Single-Blind Method; D011795:Surveys and Questionnaires
D011619:Psychotropic Drugs