The authors examined 100 psychiatric patients who were 60 years old and older for orthostatic hypotension and symptoms of dizziness and falling. Almost 40% of the patients complained of dizziness and falling, although only 27% had systolic orthostatic hypotension. Drug treatment, particularly the combination of tricyclics with other orthostatic hypotension-inducing drugs, was the most important factor accounting for the dizziness and falling. Underlying medical illness, particularly heart disease, also correlated significantly with the patients' symptoms.