Falls in older adults are a common presentation in primary care and often reflect multifactorial etiologies. Polypharmacy—particularly the use of centrally acting medications—significantly increases the risk of orthostatic hypotension, dizziness, and recurrent falls. Family physicians are well positioned to identify medication-related adverse effects early and implement deprescribing strategies to prevent morbidity and unnecessary hospital referrals.A 78-year-old woman presented to a family medicine outpatient clinic with recurrent falls over a three-month period. The falls were accompanied by dizziness and typically occurred when standing up. Her medical history included hypertension, type 2 diabetes mellitus, osteoarthritis, and hyperlipidemia. Current medications were hydrochlorothiazide, metformin, simvastatin, diazepam prescribed for insomnia, and gabapentin for chronic pain. On examination, orthostatic hypotension was detected, with a systolic blood pressure drop exceeding 20 mmHg upon standing. Cardiovascular and neurological examinations were otherwise normal. Laboratory tests, including renal function and electrolyte levels, were within normal limits. A structured medication review identified diazepam and gabapentin as likely contributors to the patient’s symptoms.This case illustrates how recurrent falls may represent a medication-related adverse effect rather than a primary neurological or cardiovascular disorder, emphasizing the diagnostic value of systematic medication review in primary care.Deprescribing centrally acting medications in older adults can significantly improve safety and functional outcomes. Primary care–based medication review should be routine in elderly patients presenting with falls or dizziness.Benzodiazepines and gabapentinoids are well known to increase fall risk through sedation and impaired postural reflexes. Addressing polypharmacy at the primary care level can reduce preventable harm.Benzodiazepines and gabapentinoids are well known to increase fall risk through sedation and impaired postural reflexes. Addressing polypharmacy at the primary care level can reduce preventable harm. Keywords (MeSH, plain text): Primary Care, Family Medicine, Polypharmacy, Falls, Orthostatic Hypotension, Older AdultsKeywords (MeSH, plain text): Primary Care, Family Medicine, Polypharmacy, Falls, Orthostatic Hypotension, Older Adults