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When it might be wise to stop taking certain medications

The Bottom Line

  • Certain drugs (e.g. for sleeping problems, depression and anxiety) increase the risk for falls and confusion, particularly in older adults who are already prone to falls and cognitive issues.
  • Stopping these medications can result in reduced risks and improved cognition.
  • Adults are advised to regularly review their medications with their family doctor.

Isn’t it often the way – you fix one problem, only to create another. It can be said about all kinds of repairs: to our homes, our cars and sometimes, more seriously, to our own health and well-being. We start taking medication for a certain problem or condition, but later discover it’s causing another health issue. Perhaps the drugs are triggering unpleasant side effects or maybe they’re reacting poorly with something else we’re taking but either way, it’s frustrating and we wonder if we’re worse off than we were before.

A good example is “psychotropic” medications which affect mood, thinking and behaviour and include sleeping pills, anxiety-reducing drugs, antidepressants and antipsychotics. While they may help improve specific symptoms, they are known to increase the risk of disorientation and falls, particularly in seniors (1). Since many older adults are already prone to falls and confusion, taking these drugs further increases the chance of falling and getting hurt (2). A potential preventative measure may be to simply stop.

What the research tells us

In recent years there has been a shift in the way health professionals view the use of medications for older adults and a growing trend toward restricting or stopping certain drugs that could have adverse side effects. This important topic is sure to be the focus of ongoing research in the coming years. Meanwhile, a recent systematic review identified and analyzed nine studies to determine whether stopping psychotropic medications would reduce falls and improve cognition in older adults. All of the study participants were 65 or older and had a history of falling and/or cognitive impairment (3).

There was evidence that stopping the drugs in question did result in fewer falls as well as improvements in cognitive abilities. Regular medication reviews by a family doctor were also shown to be an effective strategy for preventing falls and other problems associated with some drugs.

Having a bad reaction to medication can happen to anyone, but older adults are particularly vulnerable because as we age we are more likely to have multiple health issues causing us to take a number of different drugs at the same time. Sometimes that’s necessary and unavoidable however “polypharmacy,” the use of multiple medications, can pose serious risks and threats to the optimal aging process.


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References

  1. Woolcott JC, Richardson KJ, Wiens MO et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009; 169:1952-60. 
  2. Wilson NM, Hilmer SN, March LM et al. Associations between Drug Burden Index and falls in older people in residential aged care. J Am Geriatr Soc. 2011; 59:875-880.  
  3. van der Cammen TJ, Rajkumar C, Onder G et al. Drug cessation in complex older adults: time for action. Age Aging. 2014; 43:20-25.

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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