title: Use of psychotropics and the risk of falls in hospitalized psychiatric patients.
abstract: As hospitalized patients in psychiatry departments are often prescribed multiple psychotropics depending on their psychiatric symptoms, psychotropics are considered as important factors potentially associated with a high risk of falls. In this study, we attempted to investigate, from the aspect of drug prescription, to what degree the number and doses of psychotropics must be adjusted in order to reduce risk of falls in hospitalized psychiatric patients. The subjects were 526 patients, consisting of a fall group of 313 patients, who had experienced 1 to 5 falls (510 events) and a control group of 213 patients who had never experienced falls. Multiple logistic regression analysis was performed to determine the correlations between the occurrence of falls and the number and doses of psychotropics. The results showed that the risk of falls increased with increasing number of antipsychotics and anxiolytics/hypnotics prescribed, with the risk increasing, by 3.75-fold with the increase in the dose of chlorpromazine (CP)-equivalents to more than 600 mg, by 2.08-fold when the dose of diazepam (DAP)-equivalents to more than 15 mg, and by 7.80-fold with increase in CP-equivalents to more than 600 mg concomitantly with an increase in DAP-equivalents to more than 15 mg. In addition, a tendency towards increase in the frequency of falls was observed when more than 5 psychotropics were prescribed concomitantly. The above results suggested that the risk of falls may be reduced by appropriately adjusting the number of drugs and the doses of psychotropics used in the treatment of psychiatric disorders.
authors.affiliation: Department of Phamacy, Hakodate Watanabe Hospital, 1-31-1 Yunokawa-cho, Hakodate, Hokkaido 042-8678, Japan. tomombox@cameo.plala.or.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sano
authors.forename: Masashi
authors.initials: M
authors.lastname: Harada
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Sugawara
authors.forename: Naoki
authors.initials: N
authors.lastname: Isaka
authors.forename: Akio
authors.initials: A
authors.lastname: Masuoka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Mikami
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Shimamori
authors.forename: Nahoko
authors.initials: N
authors.lastname: Kurosawa
mesh_terms: D000058:Accidental Falls; D000368:Aged; D011307:Drug Prescriptions; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D011619:Psychotropic Drugs