Public Falls in Drug-Treated Patients with Diabetic Neuropathy

I know some people here take gabapentin or tricyclic antidepressants, but don't know if anyone has diabetic neuropathy.

Allan S. Brett, MD reviewing Randolph AC et al. J Am Geriatr Soc 2019 Jun

Gabapentinoids and tricyclic antidepressants might predispose these patients to falling.

Tricyclic antidepressants and gabapentinoids are used widely to treat painful diabetic neuropathy. However, their side effects (i.e., anticholinergic effects with tricyclics; dizziness with gabapentinoids; somnolence with both) could predispose patients to falling. To examine associations between use of these drugs and falls, researchers used Medicare databases to compare 5550 patients with diabetic neuropathy who received tricyclics or gabapentinoids and 22,200 propensity-matched controls with diabetic neuropathy who did not receive these drugs. The most commonly prescribed drugs were gabapentin, pregabalin, and amitriptyline (prescribed to 67%, 18%, and 10% of patients, respectively).

Use of these drugs was associated significantly with falling in two types of statistical analysis (hazard ratios, 1.11 and 1.26). The drugs also were associated with excess fracture risk (HR, ≈1.1).

https://www.jwatch.org/na49384/2019...ents-with-diabetic-neuropathy?ijkey=_O-X0pJQ5

(author's comment to be found at link)