Swallowing a handful of pills is a daily ritual for many people, from young adults coping with to older adults managing . Overall, 13% of people in the U.S. take five or more prescription drugs. For those 65 and older, that number is 42%.
If you鈥檙e taking multiple meds, it鈥檚 smart to be aware of potential problems. One pill can lead to a side effect, leading to another pill and another side effect in what experts call a 鈥減rescribing cascade.鈥�
Some drugs can cause harm if taken for years. Others stop working or interact badly with a new drug. A drug tolerated well at first can cause side effects later, leading to cognitive decline and injuries from falls.
鈥淥ur metabolism changes as we get older,鈥� said Dr. Elizabeth Bayliss, who studies deprescribing at Kaiser Permanente鈥檚 Institute for Health Research in Aurora, Colorado. 鈥淓veryone鈥檚 ability to metabolize the medications they鈥檝e been taking for a long time may change.鈥�
The nonprofit Lown Institute calls the whole situation a that will cause 4.6 million hospital visits this decade.
If your daily pill routine is getting out of hand, ask for a medication review. Here鈥檚 how to get started with a process called 鈥渄eprescribing."
Ask for a prescription checkup
Start with a professional you trust, like a doctor or pharmacist, said Lisa McCarthy, a pharmacist and deprescribing expert at the University of Toronto.
If you鈥檙e asking your doctor, don鈥檛 wait until the end of a 15-minute visit. Instead, make a dedicated appointment and tell them when booking you want to talk about your medicines, McCarthy said.
Your doctor may not have the full picture of what you鈥檙e taking if other prescribers are involved, and some doctors hesitate to manage drugs prescribed by others. That鈥檚 when a pharmacist can help by reviewing everything and writing up suggestions you can share with your doctors, said pharmacist Bradley Phillips of the University of Florida College of Pharmacy.
鈥淲e鈥檙e considered the medication experts,鈥� Phillips said.
Could my medicine be causing a problem?
Swelling, incontinence, restlessness, insomnia 鈥� all are side effects caused by common medications that sometimes get treated with new drugs. McCarthy wants people to ask their doctors a simple question: Could this symptom be related to one of my medications?
鈥淚f we could teach the public to ask that question it would be very powerful,鈥� McCarthy said. And for a follow-up question, she suggested: Do I still need this medicine?
Pharmacist Barbara Farrell sees dramatic changes in many people she helps at an outpatient geriatric center in Ottawa, Ontario. Some have emerged from a drug-induced dementia after their meds are reduced. 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 off medication takes time
Some meds can be stopped abruptly but others require a slow taper to prevent uncomfortable withdrawal symptoms 鈥� or even life-threatening seizures. Tapering to progressively lower doses is particularly important with drugs for depression, insomnia and anxiety.
After two decades on various pills for these conditions, therapist Molly Bernardi of Spokane, Washington, began tapering down her doses.
The 45-year-old suspected the pills were the cause of her worsening problems with digestion, balance, memory, stiff muscles and flickering dots across her field of vision. When scans ruled out other illnesses, she gradually stopped each of four medications.
鈥淚t鈥檚 been by far the hardest thing I鈥檝e ever done,鈥� Bernardi said.
One of the final drugs she stopped was the toughest: a benzodiazepine, a class of sedatives that can be harmful if taken long term. Over the course of three months, she used a kitchen knife and a nail file to cut her 1 milligram daily pill into ever-smaller pieces.
She listened to her body, found support groups on Facebook and used breathwork and prayer to get through withdrawal symptoms.
鈥淣ow when I have a good day, a good hour, a good moment, it鈥檚 peace and presence like I鈥檝e never known since before I was medicated,鈥� Bernardi said. 鈥淚鈥檓 just experiencing a little bit of great. And a little bit of great is so great that it keeps me going.鈥�
Be in charge of your medication list
Even in the best-connected health care systems, McCarthy said, information about prescriptions isn鈥檛 always shared among doctors. And they won鈥檛 know about your over-the-counter drugs, vitamins or nightly CBD gummy.
The only person who knows everything you take is you, McCarthy said. So keep a current list of what you take, why it was prescribed and when you started taking it.
For an example of a medication list, which McCarthy called a 鈥渢remendously powerful鈥� tool, look at the she and her colleagues designed.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Science and Educational Media Group. The AP is solely responsible for all content.
Carla K. Johnson, The Associated Press
