Medications that affect balance

Medications can save lives. They can also raise your risk of falling - by causing blurred vision, dizziness, drowsiness, dulled alertness or judgment, unsteady balance, or weakened muscles.

Sometimes the trouble comes not from any single drug but from the sheer number you take. Combining many medications can intensify the severity and frequency of side effects at any age. Older adults are especially vulnerable, since the body absorbs and responds to drugs differently as the years pass.

Drugs that increase fall risk include, among others:

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)

Anti-anxiety drugs, such as benzodiazepines

Anticholinergic and antispasmodic drugs (used for stomach cramps)

Antihistamines

Blood pressure drugs, such as diuretics, calcium channel blockers, ACE inhibitors, and angiotensin-receptor blockers (ARBs)

Diabetes drugs, such as insulin, glipizide (Glucotrol), and glyburide (DiaBeta)

Heart drugs, such as beta blockers and nitrates

Pain drugs, such as opioids and gabapentin (Neurontin)

Sleep drugs, such as zolpidem (Ambien).

Although some of these medicines are more implicated in falls than others, many are surprisingly hard to avoid.

A review in a leading medical journal examined medication use during the four months before and after a hip, shoulder, or wrist fracture among 168,133 Medicare beneficiaries. Before the fracture, three-quarters of participants had been taking at least one drug known to raise fall risk or lower bone density, like those above. Yet only 7% stopped the problematic drugs after their fracture - and an equal share started taking such drugs.

As a rule, keeping your medication count as low as possible is wise. Review your medications with your doctor routinely to make sure.