Swallowing a handful of pills is a daily ritual for many people, from young adults battling anxiety to seniors managing chronic illnesses.
Overall, 13% of Americans take at least five prescription drugs. Among people aged 65 and older, that figure rises to 42%.
If you’re taking multiple medications, it’s a good idea to be aware of potential problems. One pill can cause a side effect, then another pill and another side effect, what experts call a “prescription cascade.”
Some medications can be harmful if taken for years. Others stop working or interact poorly with a new medication. A medication that is well tolerated at first may have side effects later, leading to cognitive decline and injuries from falls.
“Our metabolism changes as we age,” said Dr. Elizabeth Bayliss, who studies deprescribing at Kaiser Permanente Health Research Institute in Aurora, Colorado. “Anyone’s ability to metabolize medications they’ve been taking for a long time can change.”
The nonprofit Lown Institute calls this situation a drug overload that will lead to 4.6 million hospital visits over the decade.
If your daily pill routine is getting out of control, get a medication review. Here’s how to begin a process called “deprescribing.”
Request a review of your prescriptions
Start by talking to a professional you trust, like a doctor or pharmacist, said Lisa McCarthy, a pharmacist and deprescribing expert at the University of Toronto.
If you do go to your doctor, don’t wait until the end of a 15-minute visit. Instead, make a specific appointment and tell him or her when you want to talk about your medications, M suggested.me McCarthy.
Your doctor may not have a complete picture of what you’re taking if other prescribers are involved, and some doctors are hesitant to cover medications prescribed by others. That’s when a pharmacist can help by reviewing everything and writing up suggestions that you can share with your doctors, says pharmacist Bradley Phillips of the University of Florida College of Pharmacy.
“We are considered experts in medicines,” he said.
Could my medication be causing a problem?
Swelling, incontinence, restlessness, insomnia – these are all side effects caused by common medications that are sometimes treated with newer drugs.me McCarthy wants people to ask their doctors a simple question: Could this symptom be related to one of my medications?
“If we could educate the public to ask that question, it would be very effective,” Mr.me McCarthy. She then suggests a follow-up question: “Do I still need this medicine?”
Pharmacist Barbara Farrell sees dramatic changes in many of the people she helps at an outpatient geriatric centre in Ottawa, Ont. Some have recovered from medication-induced dementia after their medications were reduced. A 77-year-old woman was able to get out of her wheelchair and walk with a cane after reducing her daily pills from 32 to 17. She had become sedated and unable to communicate, and within months she was back to her hobby of knitting.
Be responsible for your medication list
Some medications can be stopped abruptly, but others require gradual tapering to avoid unpleasant withdrawal symptoms or even life-threatening seizures. Gradual tapering is especially important for medications for depression, insomnia, and anxiety.
Even in the best-connected health systems, prescription information isn’t always shared among doctors. Nor do they know what over-the-counter medications, vitamins, or CBD gummies you’re taking at night.
The only person who knows everything you take is you, Mr.me McCarthy: So keep an up-to-date list of what you’re taking, why it’s prescribed to you, and when you started taking it.
For an example of a list of medications, let Mme McCarthy calls it an “extremely powerful” tool, check out the workshop materials she and her colleagues have designed.