Falls in Drug-Treated Patients with Diabetic Neuropathy

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 fa…