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Dizziness and falling in elderly psychiatric outpatients

M D Blumenthal, J W Davie

    The American Journal of Psychiatry
    |February 1, 1980
    PubMed
    Summary

    Nearly 40% of older psychiatric patients experienced dizziness and falls, often linked to medications like tricyclics. Underlying conditions, especially heart disease, also contributed to these symptoms in elderly individuals.

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    Area of Science:

    • Geriatric Medicine
    • Psychiatry
    • Pharmacology

    Background:

    • Orthostatic hypotension and associated symptoms like dizziness and falls are common concerns in elderly psychiatric patients.
    • Polypharmacy and specific drug classes are frequently implicated in adverse events in this population.

    Purpose of the Study:

    • To investigate the prevalence of orthostatic hypotension and symptoms of dizziness and falling in older psychiatric patients.
    • To identify key contributing factors, including medications and underlying medical conditions, associated with these symptoms.

    Main Methods:

    • A cohort of 100 psychiatric patients aged 60 years and older was assessed.
    • Evaluations included screening for orthostatic hypotension and detailed inquiry about dizziness and falling episodes.
    • Medication regimens and presence of underlying medical illnesses were systematically recorded.

    Main Results:

    • Almost 40% of patients reported symptoms of dizziness and falling.
    • Systolic orthostatic hypotension was present in 27% of the cohort.
    • Tricyclic antidepressants, particularly in combination with other drugs inducing orthostatic hypotension, were strongly associated with symptoms.
    • Underlying medical conditions, notably heart disease, showed a significant correlation with dizziness and falling.

    Conclusions:

    • Medication side effects, especially from combined drug therapies, are a primary driver of dizziness and falls in elderly psychiatric patients.
    • Underlying medical comorbidities significantly increase the risk of these symptoms.
    • Clinical attention to medication review and management of comorbidities is crucial for preventing falls in this vulnerable group.

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