Q: You've mentioned that some medications affect balance. Which ones? If a drug I'm taking is affecting my balance, what can I do about it?
A: There are enough of them that I don't have space to mention them all. Medicines that affect balance in some people may not do so in you. In fact, most people can take medicines that can cause balance problems, without having the medicines affect their balance.
If you already have problems with balance, whenever your doctor recommends a new medicine, ask if it will affect your balance. If so, is there a better alternative?
The real concern here is falling. Falls are more likely when medicines affect not only balance but also vision, or if they impair alertness or judgment. Some medications may damage the inner ear, which can cause temporary or permanent balance problems.
Often, it's the sheer number of medicines, rather than a single drug, that causes problems. Taking many medications at the same time can boost the severity and frequency of side effects. Older adults are especially vulnerable, because drugs are absorbed and broken down differently as we age.
Unfortunately, many of the most commonly prescribed drugs can play a role in falls. This possible side effect must be weighed against the other health benefits of the drugs. The lengthy list includes drugs from the following categories:
-âAntidepressant and anti-anxiety drugs
-âBlood pressure drugs
-âAntiarrhythmics, vasodilators and digoxin (heart drugs)
-âPain relievers such as opioids and nonsteroidal anti-inflammatory drugs
If you have side effects that affect your balance, vision or state of alertness, talk to your doctor. Ask for a review your medications. Bring all your prescription and nonprescription medications and supplements with you. Or at least bring a complete list.
Your doctor may consider different strategies to reduce your risk of falling. These include:
-âPruning the list.
-âLowering your dose.
-âSwitching to a different drug.
-âChanging the time of day you take the drug.
Redoubling your efforts to make lifestyle changes could also help lower the dose - or entirely eliminate - one or more drugs from your list. You may be able to take lower doses of diabetes and blood pressure drugs, for example, if you step up your exercise and eat better.
It may take trial and error for you and your doctor to find the right medicines or the right dose to achieve health benefits, while avoiding the side effects that increase your risk of falls. But it usually can be done successfully.
DR. ANTHONY KOMAROFF is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.askdoctork.com.