Psychotropic drug use and the risk of hip fracture

W. A. Ray, M. R. Griffin, W. Schaffner, D. K. Baugh, L. J. Melton

Research output: Contribution to journalArticle

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Abstract

To assess the risk of hip fracture associated with the use of four classes of psychotropic drugs, we performed a case-control study of 1021 patients with hip fractures and 5606 controls among elderly Medicaid enrollees. Persons treated with hypnotics - anxiolytics having short (≤ 24 hours) elimination half-lives had no increased risk of hip fracture. By contrast, a significantly increased risk was associated with current use of hypnotics-anxiolytics having long (> 24 hours) elimination half-lives (odds ratio, 1.8; 95 percent confidence interval, 1.3 to 2.4), tricyclic antidepressants (odds ratio, 1.9; 95 percent confidence interval, 1.3 to 2.8), and antipsychotics (odds ratio, 2.0; 95 percent confidence interval, 1.6 to 2.6). The risk increased in relation to the doses of drugs in these three classes. An analysis for possible confounding by dementia did not alter the results. Previous but non-current use of drugs in these classes conferred no increase in risk. Although a cause-and-effect relation was not proved, these data support the hypothesis that the sedative and autonomic effects of psychotropic drugs increase the risk of falling and fractures in elderly persons. The results suggest the need for studies of this association in other populations and for evaluation of newer psychotropic drugs with fewer undesirable sedative and autonomic effects.

Original languageEnglish (US)
Pages (from-to)363-369
Number of pages7
JournalNew England Journal of Medicine
Volume316
Issue number7
StatePublished - 1987

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Psychotropic Drugs
Hip Fractures
Hypnotics and Sedatives
Autonomic Agents
Odds Ratio
Anti-Anxiety Agents
Confidence Intervals
Accidental Falls
Tricyclic Antidepressive Agents
Medicaid
Pharmaceutical Preparations
Antipsychotic Agents
Dementia
Case-Control Studies
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ray, W. A., Griffin, M. R., Schaffner, W., Baugh, D. K., & Melton, L. J. (1987). Psychotropic drug use and the risk of hip fracture. New England Journal of Medicine, 316(7), 363-369.

Psychotropic drug use and the risk of hip fracture. / Ray, W. A.; Griffin, M. R.; Schaffner, W.; Baugh, D. K.; Melton, L. J.

In: New England Journal of Medicine, Vol. 316, No. 7, 1987, p. 363-369.

Research output: Contribution to journalArticle

Ray, WA, Griffin, MR, Schaffner, W, Baugh, DK & Melton, LJ 1987, 'Psychotropic drug use and the risk of hip fracture', New England Journal of Medicine, vol. 316, no. 7, pp. 363-369.
Ray WA, Griffin MR, Schaffner W, Baugh DK, Melton LJ. Psychotropic drug use and the risk of hip fracture. New England Journal of Medicine. 1987;316(7):363-369.
Ray, W. A. ; Griffin, M. R. ; Schaffner, W. ; Baugh, D. K. ; Melton, L. J. / Psychotropic drug use and the risk of hip fracture. In: New England Journal of Medicine. 1987 ; Vol. 316, No. 7. pp. 363-369.
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