Hidden Dangers: NSAIDs, Benzos and Antipsychotics Top the Beers List

Millions of older Americans take medications every day without realizing some of the most common prescriptions and over-the-counter drugs may carry serious risks later in life. Doctors and pharmacists often rely on something called the “Beers Criteria,” a medical guideline that identifies medications that may be potentially inappropriate or dangerous for adults over 65. The list is maintained by the American Geriatrics Society and is widely used to reduce falls, confusion, hospitalizations, and dangerous drug interactions in older adults. Some of the most concerning medications on the Beers List include NSAIDs, benzodiazepines, and antipsychotics because aging bodies process these drugs differently than younger adults. Here’s what you need to know about what doctors are recommending now.

What the Beers List Actually Means for Older Adults

The Beers List is not a list of “banned” medications, but rather a safety guide designed to help healthcare providers weigh risks versus benefits in older patients. As people age, the liver and kidneys often process medications more slowly, which can allow drugs to remain in the body longer and increase side effects. According to the Cleveland Clinic, more than 90% of adults over 65 take at least one prescription medication, and roughly two-thirds take three or more medications regularly. That combination dramatically raises the risk of drug interactions, dizziness, confusion, and falls. The Beers List exists because medications that may be relatively safe for younger adults can become much more dangerous in aging bodies.

NSAIDs Can Trigger Bleeding, Kidney Problems and Dangerous Falls

Many people are surprised to learn that common pain relievers like ibuprofen and naproxen appear on the Beers List for older adults. NSAIDs, or nonsteroidal anti-inflammatory drugs, are widely used for arthritis, back pain, and joint inflammation, but long-term use can increase the risk of stomach ulcers, gastrointestinal bleeding, and kidney damage in seniors. Mayo Clinic experts warn that NSAIDs may also contribute to confusion, dizziness, and balance problems that can increase fall risk. This becomes especially concerning because falls remain one of the leading causes of injury-related hospitalization among older Americans. Even over-the-counter medications can become dangerous when used frequently or combined with blood thinners and other prescriptions.

Benzodiazepines Raise Serious Concerns About Memory and Falls

Benzodiazepines, often called “benzos,” include medications such as Xanax, Ativan, and Valium that are commonly prescribed for anxiety, insomnia, or panic attacks. Doctors advise caution because these medications can cause drowsiness, slowed reaction times, memory problems, and loss of balance in older adults. Federal health researchers note that the Beers List specifically recommends avoiding benzodiazepines in many adults over 65 because of the increased risk of fractures, falls, and dangerous sedation. The risk becomes even higher when benzodiazepines are combined with opioids or alcohol, which can slow breathing and increase overdose danger. Many healthcare providers now encourage gradual tapering strategies or safer alternatives because older adults often metabolize benzodiazepines much more slowly.

Antipsychotics Can Carry Life-Threatening Risks in Seniors

Antipsychotic medications are sometimes used to treat schizophrenia, bipolar disorder, severe agitation, or dementia-related behavioral symptoms, but they come with major warnings for older adults. The Beers List highlights antipsychotics because they may increase the risk of stroke, cognitive decline, delirium, and even death in seniors with dementia. Families are often shocked to discover that medications intended to calm agitation can sometimes worsen confusion or increase sedation significantly. Physicians on medical forums frequently warn that using sedating medications simply to reduce fall risk or agitation can backfire and create additional complications. These drugs may still be medically necessary in certain situations, but experts stress they should be used carefully and monitored closely.

Polypharmacy Makes the Risks Even More Dangerous

One medication alone may not seem like a major problem, but combining several high-risk drugs can create a dangerous domino effect for seniors. Doctors refer to this issue as “polypharmacy,” which means taking multiple medications at the same time. A senior taking an NSAID for arthritis, a benzodiazepine for sleep, and another medication for blood pressure may suddenly experience dizziness, confusion, or serious balance issues. Healthcare professionals on Reddit and in geriatric care settings often describe seeing older patients whose falls and cognitive decline improved after medication reviews reduced unnecessary prescriptions. The Beers List is especially valuable because it helps providers identify combinations of medications that can quietly increase risk over time.

Seniors Should Never Stop Medications Without Medical Guidance

Seeing a medication on the Beers List does not automatically mean someone should stop taking it immediately. Health in Aging experts specifically warn that patients should always speak with a healthcare provider or pharmacist before making medication changes because abrupt withdrawal can sometimes create dangerous side effects. In many cases, doctors may determine that the benefits of a medication still outweigh the risks, depending on a person’s health condition and quality of life. The goal of the Beers List is not fear, but awareness and safer prescribing practices for older adults. Medication reviews, lower doses, alternative therapies, and regular follow-ups can often reduce risk while still treating important health problems effectively.

Medication Safety Matters More With Age

The Beers List has become one of the most important tools doctors use to help protect older adults from avoidable medication-related harm. NSAIDs, benzodiazepines, and antipsychotics remain on the list because they can increase risks tied to falls, confusion, bleeding, cognitive decline, and dangerous drug interactions. That does not mean every medication on the list is automatically unsafe, but it does mean older adults deserve careful monitoring and honest conversations about side effects. Seniors and caregivers who regularly review medications with healthcare providers are often better positioned to catch problems before they become emergencies. The simple act of asking, “Is this medication still the safest option for me?” can sometimes prevent serious complications later.

Have you or a loved one ever experienced unexpected side effects from a medication listed on the Beers List? Share your experience in the comments below.

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Amanda Blankenship

Amanda Blankenship is the Chief Editor for District Media. With a BA in journalism from Wingate University, she frequently writes for a handful of websites and loves to share her own personal finance story with others. When she isn’t typing away at her desk, she enjoys spending time with her daughter, son, husband, and dog. During her free time, you’re likely to find her with her nose in a book, hiking, or playing RPG video games.