Deprescribing professionals emphasize the need of managing drug overload in order to avoid injury and unwanted consequences. Swallowing a handful of tablets is a daily habit for many people, including young adults dealing with anxiety and elderly folks managing chronic diseases.

Overall, 13% of persons in the United States use five or more prescription medicines. For those 65 and older, the figure is 42%. If you’re taking various medications, it’s important to be aware of potential issues. One pill can have a side effect, which can lead to another pill and another adverse effect in what specialists refer to as a “prescribing cascade.”  

Some medications, when used for an extended period of time, can be harmful. Others quit working or react negatively to a new medicine. A medicine that is well tolerated initially can induce negative effects later on, including cognitive deterioration and falls. “Our metabolism changes as we get older,” said Dr. Elizabeth Bayliss, who researches deprescribing at Kaiser Permanente’s Institute for Health Research in Aurora, Colorado. “Everyone’s ability to metabolize the medications they’ve been taking for a long time may change.”

The nonprofit Lown Institute describes the problem as a drug overload, which will result in 4.6 million hospital visits this decade. If your daily pill habit is becoming out of control, request a medication review. Here’s how to begin the process of “deprescribing.”  

Ask for a prescription checkup

Lisa McCarthy, a pharmacist and deprescribing expert at the University of Toronto, recommends starting with a trusted practitioner, such as a doctor or pharmacist. If you want to ask your doctor something, don’t wait until the conclusion of your 15-minute session. Instead, schedule a dedicated session and specify that you want to discuss your medications, according to 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 handle medicines prescribed by others. That’s when a pharmacist may help by examining everything and writing up recommendations to share with your doctors, according to Bradley Phillips of the University of Florida College of Pharmacy. “We’re considered the medication experts,”  Phillips said

Could my medication be causing an issue?

Side effects from typical medications include swelling, incontinence, restlessness, and insomnia, which are occasionally managed with additional prescriptions. McCarthy wants patients to ask their doctors a simple question: Is this symptom related to one of my medications? “If we could teach the public to ask that question it would be very powerful,” Mr. McCarthy added. As a follow-up question, she suggested: Do I still need this medication?

Barbara Farrell, a pharmacist at an outpatient geriatric center in Ottawa, Ontario, notices major changes in many of the patients she serves. Some people have recovered from drug-induced dementia when their medications were lowered. She returned to knitting, her pleasure. A 77-year-old woman was able to leave her wheelchair and walk with a cane after cutting her daily pills from 32 to 17. She had arrived sedated and unable to communicate, and a few months later, she was back to her hobby of knitting.

Weaning from medicine takes time

Some medications can be discontinued immediately, while others require a gradual taper to avoid unpleasant withdrawal symptoms – or even life-threatening seizures. Tapering to progressively lower doses is especially critical for medicines used to treat depression, sleeplessness, and anxiety. After two decades of taking several medications for these illnesses, therapist Molly Bernardi of Spokane, Washington, began reducing her doses.

The 45-year-old felt that the drugs were to blame for her failing digestion, balance, memory, stiff muscles, and flashing dots in her field of vision. After scans ruled out additional conditions, she gradually discontinued each of the four drugs. “It’s been by far the hardest thing I’ve ever done,” Bernardi added.  

One of the last drugs she quit was a benzodiazepine, a type of sedative that can be dangerous if used for an extended period of time. Over three months, she used a kitchen knife and a nail file to chop her daily 1 mg medication into increasingly little pieces. She listened to her body, discovered support groups on Facebook, and dealt with withdrawal symptoms with breathwork and prayer.

“Now when I have a good day, a good hour, a good moment, it’s peace and presence like I’ve never known since before I was medicated,” Bernardi said. “I’m simply having a little bit of amazing. And a tiny bit of greatness is enough to keep me going.  

Take ownership of your medicine list.

Even in the best-connected health-care systems, McCarthy noted, doctors don’t always share prescription information. They’ll also be unaware of any over-the-counter medications, vitamins, or CBD gummies you take every night.

McCarthy stated that the only person who knows what you take is you. Maintain a current list of what you take, why it was prescribed, and when you started taking it. Look at the workshop materials McCarthy and her colleagues produced to see an example of a medication list, which McCarthy described as a “tremendously powerful” tool.  

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Source: HT