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We present a case of asterixis as a cause of falls and near falls in a patient with metastatic breast cancer and normal mental status who was receiving gabapentin. Painful conditions, like neuropathy, significantly increase the risk of falls in older adults, as can the medications used to treat those painful conditions. One of the most common medications used to treat these painful conditions is gabapentin. In 2020, nearly 50 million prescriptions for gabapentin were written, but after several studies highlighted potential safety concerns, 20% fewer Gabapentin is not associated with a greater risk of falls in older adults with neuropathy or fibromyalgia, according to a study published in Annals of Internal Medicine. The comparator study using a target trial emulation framework compared the risk for fall-related visits and hospitalizations in the six months after initiating gabapentin versus duloxetine among patients with evidence of To compare the risk for fall-related visits from gabapentin versus duloxetine, researchers studied data from 57,086 adults ages 65 years or older with diabetic neuropathy, postherpetic neuralgia, or fibromyalgia who were newly prescribed either drug between January 2014 and December 2021. By Ellen Feldman, MD Synopsis: This retrospective study examining fall risk among older adults taking gabapentin compared to duloxetine finds gabapentin users exhibit a markedly lower risk of fall-related visits at six months (hazard ratio = 0.52) yet finds no difference in the incidence of severe falls. Source: Chaitoff A, Desai RJ, Choudhry NK, et al. Assessing the risk for falls in older Gabapentin Doesn't Increase Fall Risk, Study Suggests News Article 1/9/2025 Adobe Stock THURSDAY, Jan. 9, 2025 (HealthDay News) -- A pain-relieving medication might be safer for seniors than first thought. 3. Fall Risk Gabapentin may increase the risk of falls in elderly patients, particularly when combined with other medications. A 2024 study by Painter et al. found that concurrent use of high-dose opioids and gabapentin was associated with a higher all-cause mortality risk in Medicare beneficiaries, potentially due to increased fall risk. 4. Gabapentin is a medication that is commonly prescribed for the treatment of epilepsy and neuropathic pain. However, recent studies have raised concerns about its potential link to an increased risk of falls in certain populations. Falls are a major public health concern, especially among older adults. They can result in serious injuries, hospitalizations, and even death. Therefore, it is 1. Increased risk of falls and fractures: The dizziness and balance issues associated with gabapentin can significantly increase the risk of falls in older adults. This is particularly concerning given the potential for serious injuries and long-term complications from falls in the elderly population. 2. Gabapentin is commonly prescribed and has shown potential utility in decreasing alcohol consumption among treatment‐seeking and non‐treatment‐seeking populations. We sought to determine its association with neurologic events (falls or fractures and altered mental status) among patients receiving gabapentin for any indication. In this national study of over 500,000 patients, gabapentin We would like to show you a description here but the site won’t allow us. By Ellen Feldman, MD Synopsis: This retrospective study examining fall risk among older adults taking gabapentin compared to duloxetine finds gabapentin users exhibit a markedly lower risk of fall-related visits at six months (hazard ratio = 0.52) yet finds no difference in the incidence of severe falls. Source: Chaitoff A, Desai RJ, Choudhry NK, et al. Assessing the risk for falls in older In studies, antidepressants have been found to increase the risk for falls and injuries. Possible mechanisms include their potential to cause sedation and postural disturbances, although these effects vary by agent and individual. Additionally, antidepressants may be indirectly associated with fall risk due to factors such as poor health status, depression, and weight loss. In studies New use of gabapentin (Neurontin) was not associated with greater risk of falls in older adults with neuropathy or fibromyalgia compared with new use of duloxetine (Cymbalta), a commercial claims Patients whose falls were linked to opioid use were also more likely to die during their hospital stay.10 Anticonvulsants All anticonvulsants including gabapentin, levetiracetam, phenytoin, and valproate increase fall risk. Side effects contributing to fall risk include ataxia, impaired psychomotor function, and syncope.6 Background: The evidence informing the harms of gabapentin use are at risk of bias from comparing users with nonusers. Objective: To describe the risk for fall-related outcomes in older adults starting treatment with gabapentin versus duloxetine. Design: New user, active comparator study using a target trial emulation framework. Setting: MarketScan (IBM) commercial claims between January 2014 Gabapentin does not increase fall-related visits in older adults compared to duloxetine, with a lower fall risk over six months. Accurate risk/benefit assessments for pain medications are crucial, as patients often feel undertreated. FDA accepted Tonix Pharmaceuticals' NDA for TNX-102 SL, potentially the first new fibromyalgia treatment in 15 A team from the University of Michigan School of Medicine, Brigham and Women’s Hospital, and Harvard Medical School sought to describe the risk for fall-related outcomes in older adults starting treatment with gabapentin versus duloxetine, using a new user, active comparator study utilizing a target trial emulation framework. Drugs used for fibromyalgia often increase risk of falling. Research showed that six months after treatment started, fall risk did not increase with gabapentin. Excess risk of falls or fractures associated with gabapentin exposure was observed in all subgroups except patients with HCV, HIV, or AUD; however, these groups had elevated incidence regardless of exposure.
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