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The effects of fall-risk-increasing drugs on postural control: A literature review

机译：降低秋天风险的药物对姿势控制的影响：文献综述

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Meta-analyses showed that psychotropic drugs (antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs) and some cardiac drugs (digoxin, type IA anti-arrhythmics, diuretics) are associated with increased fall risk. Because balance and gait disorders are the most consistent predictors of future falls, falls due to use of these so-called fall-risk-increasing drugs (FRIDs) might be partly caused by impairments of postural control that these drugs can induce. Therefore, the effects of FRIDs on postural control were examined by reviewing literature. Electronic databases and reference lists of identified papers were searched until June 2013. Only controlled research papers examining the effects of FRIDs on postural control were included. FRIDs were defined according to meta-analyses as antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs, digoxin, type IA anti-arrhythmics, and diuretics. Ninety-four papers were included, of which study methods for quantifying postural control, and the effects of FRIDs on postural control were abstracted. Postural control was assessed with a variety of instruments, mainly evaluating aspects of body sway during quiet standing. In general, postural control was impaired, indicated by an increase in parameters quantifying body sway, when using psychotropic FRIDs. The effects were more pronounced when people were of a higher age, used psychotropics at higher daily doses, with longer half-lives, and administered for a longer period. From the present literature review, it can be concluded that psychotropic drugs cause impairments in postural control, which is probably one of the mediating factors for the increased fall risk these FRIDs are associated with. The sedative effects of these drugs on postural control are reversible, as was proven in intervention studies where FRIDs were withdrawn. The findings of the present literature review highlight the importance of using psychotropic drugs in the older population only at the lowest effective dose and for a limited period of time.
机译：荟萃分析表明，精神药物（抗抑郁药，抗精神病药，苯二氮卓类药物，抗癫痫药）和某些心脏药物（地高辛，IA型抗心律不齐药物，利尿剂）与跌倒风险增加相关。由于平衡和步态障碍是未来跌倒的最一致的预测因素，因此，使用这些所谓的“增加跌倒风险的药物”（FRID）引起的跌倒可能部分是由这些药物可能导致的姿势控制障碍引起的。因此，通过回顾文献研究了FRIDs对姿势控制的作用。检索电子数据库和已鉴定论文的参考文献清单，直至2013年6月。仅纳入检查FRID对姿势控制作用的对照研究论文。根据荟萃分析将FRID定义为抗抑郁药，抗精神病药，苯二氮卓类药物，抗癫痫药，地高辛，IA型抗心律失常药和利尿剂。包括94篇论文，其中量化姿势控制的研究方法，并提取了FRIDs对姿势控制的影响。使用各种仪器评估姿势控制，主要是评估安静站立时身体摇摆的各个方面。通常，使用精神病性FRID时，姿势控制会受到损害，这是通过量化身体摇摆的参数增加来表明的。当人们年龄较大，使用精神药物的日剂量较高，半衰期较长且给药时间较长时，效果会更加明显。从目前的文献综述中，可以得出结论，精神药物会导致姿势控制受损，这可能是这些FRID与跌倒风险增加的中介因素之一。这些药物对姿势控制的镇静作用是可逆的，正如在撤回FRIDs的干预研究中所证明的那样。本文献综述的结果突出了仅在最低有效剂量和有限的时间内在老年人中使用精神药物的重要性。

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