One hundred community-dwelling psychiatric outpatients, 60 years and older, were evaluated for factors associated with symptoms of dizziness, falling, and orthostatic hypotension. Thirty-nine percent complained of dizziness or falling, and 34% had systolic orthostatic hypotension. Together, systolic and diastolic blood pressure drop, type of somatic illness, type and number of drugs, and psychiatric diagnosis accounted for 50% of the variance in dizziness and falling. Type of illness, drug category, and psychiatric diagnosis accounted for only 19% of the variance in orthostatic hypotension. Statistical analysis showed that systolic orthostatic hypotension, disease classification, and type and number of drugs taken contribute independently to dizziness and falling. In geriatric psychiatric patients, careful attention to orthostatic hypotension, concurrent somatic illness, and number and type of medication is essential to the prevention of dizziness, falling, and their consequences.