Will stopping certain medications help reduce the risk of falls in older adults?

Falls are a major cause of injury in older adults, and certain medications—especially psychotropics, sedatives, and anticholinergics—can increase fall risk. Deprescribing, or carefully stopping or reducing these medications under medical supervision, is a strategy to lower that risk. Research shows that when deprescribing is done with high fidelity (meaning the intervention is thorough and well-executed), it can significantly reduce falls. However, not all deprescribing efforts are equally effective, and results depend on how the program is implemented.

What the research says

A 2025 systematic review and meta-analysis looked at deprescribing interventions that specifically targeted psychotropic medications (like sedatives, antidepressants, and antipsychotics) in adults aged 65 and older ³. In long-term community studies, these interventions did not significantly reduce falls overall. However, when the analysis focused on high-fidelity interventions—those that were more intensive and closely followed—the odds of falling dropped by about 39% (odds ratio 0.61) ³. This suggests that simply telling patients to stop a medication may not be enough; a structured, well-supported deprescribing process is key.

Another study tested a telemedicine-based fall prevention program (STEADI) that included medication reviews and recommendations ². The program did not show a significant difference in self-reported falls compared to standard care. This may be because the recommendations were optional for doctors, and the intervention may not have been implemented with enough intensity ².

Pharmacists can play a valuable role in fall prevention by reviewing medications and identifying those that increase fall risk ⁷. The CDC's STEADI initiative provides tools for healthcare teams, including pharmacists, to help manage fall risk ⁷. A planned trial called PARTNER will test a collaborative approach where general practitioners and pharmacists work together to deprescribe psychotropics, sedatives, and anticholinergics in older adults with polypharmacy (taking 5 or more drugs) ⁹. This kind of team-based care may improve deprescribing success.

Overall, the evidence supports that deprescribing certain medications can reduce falls, but the effect depends on the quality of the intervention. High-fidelity programs that involve careful medication review, patient education, and follow-up are more likely to be effective ³.

What to ask your doctor

• Could any of my current medications be increasing my fall risk?
• Would a medication review with a pharmacist be helpful for me?
• Are there any psychotropic, sedative, or anticholinergic drugs I take that might be candidates for deprescribing?
• What would a deprescribing plan look like for me, and how would we monitor my progress?
• Is there a fall prevention program (like STEADI) available that includes medication management?