For several decades, geriatricians have used antidepressants with caution and have largely proscribed benzodiazepines, in part because of a higher incidence of falls with their use. In an extensive review, Woolcott et al1 examined the risk of falls in elderly persons taking various medications and confirmed that antidepressants and benzodiazepines were 2 medication classes with increased risk. However, their findings may be confounded if the condition for which the medication has been prescribed is independently related to an increased frequency of falls (and fall-related fractures). Although Woolcott et al1 attempted to adjust for this “confounding by indication,” it seems unlikely that the propensity score calibration they used can alone adequately correct for this type of confounding.
Lesser GT. Medication and Falls in Elderly Persons. Arch Intern Med. 2010;170(9):834-835. doi:10.1001/archinternmed.2010.122