I recently discovered that a few of my over-40 patients appeared to be over-medicated from a combination of prescription drugs they had been given by different doctors. They came in complaining of not feeling well and said that they had been taking all of their prescriptions.
When I asked them what prescription medications they were taking, some reeled off a long list of drugs and others would bring in all of their pill bottles. One person was taking so many prescription drugs that they kept them in a shoe box! I was astounded at the amount of prescription drugs some were taking daily, often with duplicates and triplicates of the same types of drugs. No wonder they were feeling so poorly, complaining of things like memory loss, weakness, and stomach upsets.
Today, I’d like to talk to you about the potentially serious health risk of over-medication and how to prevent it.
How To Prevent Over-Medication
Over-medication is commonly referred to amongst medical personnel as polypharmacy, the taking of an excessive amount of prescription, pharmaceutical drugs. It is actually reaching epidemic proportions in the United States today, and it’s most common in over-65 patients. It also occurs, however, in younger patients with multiple health conditions, including people who may be taking over 20 different drugs a day!
A patient may unknowingly be taking several prescriptions of the same types of drugs. How is that possible? Well, here’s how.
A new patient came to me complaining about feeling ill with symptoms that were not related to her asthma condition. It was discovered that she was taking 5 different drugs, when only 2 were needed She had seen a few different doctors in the past and all had prescribed a drug for her condition. Trying to trust her doctors and follow their orders, she had just continued to take all of them! When we omitted the 3 extra drugs, her symptoms and ill-feelings disappeared.
Unfortunately, over-medication is not often discovered until a patient winds up in the hospital from either an overdose, or when they become ill from over-treatment, and/or side effects from taking too much of certain drugs. Sometimes a pharmacist notes that a patient has several doctors prescribing similar types of drugs and will alert the patient and/or physicians.
Did you know that 1.5 million adverse drug reactions occur in the United States every year, with thousands of them fatal? Research has shown that over half of all those events could have been prevented by streamlining a patient’s drugs to the actual symptoms and effects of their specific medical condition. We’ve become, sadly, a culture of “a pill for every ailment”. What can happen when a patient starts complaining about possible side effects from too many drugs is that another doctor will step in and prescribe a different medication for the same symptoms! Pretty soon, the patient is taking a whole arsenal of pills and not feeling any better. The answer is not to stop telling your doctor about ill feelings from possible side effects, but rather to better monitor the drugs you are given.
Before you end up in a hospital from an overdose or making yourself feel worse from taking too many medications, here are some ways to prevent from becoming over-medicated
Talk to your pharmacist – ask if any of the medications you are taking could be causing certain side effects. Pharmacists often know specific side effects and drug interactions of specific drugs better than many doctors do. That’s their job. It is important to tell them about any prescriptions you may have received from another pharmacy that you are continuing to take, as they will only know about the drugs dispensed from their pharmacy to you. This will help rule out duplicates of the same class of drugs, i.e. drugs for diabetes, drugs for heart condition, tranquilizer drugs, pain drugs, etc.
Talk to your physician – ask your doctor if it is possible to reduce the amount of drugs you are taking every day or week. Give the physician any information obtained from your pharmacist, i.e., drug information sheets that should include side effects or drug interactions. Or, have your doctor speak directly to your pharmacist about the drugs you are taking. It is likely the two of them can work out a more efficient pill taking regimen. Some physicians may feel insulted that you’re asking them to work with a pharmacist on your behalf to reduce the amount of your prescriptions and may even reprimand you for not trusting him or her. If so, find another doctor.
Take Your Medications Correctly – it’s not always the doctor’s fault. Some people do not take their prescribed medications correctly or just don’t take them at all. They continue to complain of symptoms and continue to have abnormal lab results, but are embarrassed to tell their doctor they didn’t take their prescriptions consistently. A doctor may then think that the drug he prescribed to you is not working and may either increase the dosage or give you another prescription! Be sure to follow the directions on your prescription bottles exactly. Get a pill reminder box and fill it, or have someone you trust, fill it every week to ensure you are taking your medication as prescribed.
Know What Each Medication Is – it’s up to you to participate in your health care. Know what each medication you take is for and how to take it correctly. Read the drug information sheets that are given by your pharmacy, discuss any questions with the pharmacist and/or your physician.
Don’t Forget OTC’s and Alternatives – even though these agents are sold “over-the-counter” they sometimes may interact adversely with prescription drugs or prevent them from working. Make sure you tell your doctor about any herbal supplements, vitamins, minerals, pain relievers, etc. For example, calcium cannot be taken within 3-4 hours of taking thyroid hormone as it will inactivate it. Grapefruit extract, an herbal supplement which some people take, can also interact with and/or prevent certain drugs from working. This is why it is important to detail everything you take.
Like some of my patients, you may need to take several prescription medications for various health issues that you may have. However, if you are taking a long list of medications, there is a risk that you may be over-medicating and you should take the time to talk to your doctor about possibly having your personal “pharmacy” reduced to a more effective, and safe, amount.
Mark Rosenberg, M.D.