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February 21, 2017

Taking Too Many Medications? Deprescribing Could Help

If you’re like most older Americans, you probably have a pill organizer for each day of the week, or at least a bottle or two of medication you take daily. Research has shown that nearly 40 percent of people in their 60s take at least five medications.

For many of us, taking multiple medications often means visits to different specialists or doctors — and these medications could be producing unhealthy side effects or interactions. How can you tell if you're taking too many medications?

Could Deprescribing be the Answer?

You’ve certainly heard of prescribing a medicine, but now a pair of doctors are advocating for the opposite — deprescribing. It works like this: You and your doctor evaluate your medications for their effectiveness, and based on what you find, either stop taking a medication or reduce the dosage.

“Medications that were good then, might not be the best choice now. Deprescribing is part of good prescribing — backing off when doses are too high, or stopping medications that are no longer needed,” explain Drs. Barbara Farrell and Cara Tannenbaum.

Farrell and Tannenbaum theorize that the use of some medications can cause more harm than good, especially as you age.

The changes in your physiology and metabolism that come with age can affect how your body processes drugs, possibly leading to more side effects or interactions.

“Medications like sleeping pills and antidepressants can cause confusion or dizziness and can contribute to falls. Even blood pressure medicines — particularly when they're first prescribed — could increase the risk of falls and serious injury. For example, if prescribed a medication which causes some dizziness, a patient may get a second medication for the dizziness, which also has a side effect. The cumulative effective of the medications puts people at risk for falls,” say Drs. Anthony Zizza and Sarah Barry.

The American Geriatric Society has identified three sets of medications that can be especially problematic for older adults. Doctors encourage patients to either avoid them or use the lowest dose possible:

  • Benzodiazepines like Valium or Xanax, which are used to treat anxiety, depression or insomnia
  • Over-the-counter sleeping medicines like Benadryl, which can cause confusion
  • Over-the-counter medicines like NSAIDs, which can damage the kidneys or stomach

How to Talk to Your Doctor About Reducing Your Medications

If you’d like to examine more closely your medications and why you’re taking them, ask your doctor to review your medications to see if any can be reduced or stopped. You can also ask these questions when you visit the doctor, nurse or pharmacist:

  • Have any medications been added, changed or stopped, and why?
  • What medications do I need to continue taking and why?
  • How do I take my medications and for how long?
  • How will I know if my medication is working and what side effects do I watch for?
  • Do I need any tests and when do I follow up?

If you’d like to reduce or stop taking a medication, or if your doctor recommends you do so, ask these questions:

  • Do I need to continue my medication?
  • How do I reduce my dose?
  • Is there an alternative treatment?
  • What symptoms should I watch for when I discontinue my medication?
  • With whom do I follow up and when?

While medications have benefits, taking some for long periods of time or after they’ve served their purpose can lead to unwanted side effects and possibly dangerous interactions. Stay as healthy as possible by regularly examining your medications, noting side effects and interactions and asking your doctor or pharmacist if any can be discontinued or reduced.

Better Medication Management

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