Does it seem like everyone you know is taking medication, including you? Prescription medications are on the rise, particularly among baby boomers…on up. Overmedication can creep up on you: First, you’re taking a statin, then an NSAID for your arthritis, plus a sleeping pill a few times a week, maybe an antidepressant, a blood pressure medication, and one day you…just don’t feel very well.
“Overmedication side effects can be very difficult to distinguish from an underlying medical condition,” says geriatrician Michael Steinman, M.D., associate professor of medicine at University of California San Francisco School of Medicine. “You’re feeling lightheaded, or you have an upset stomach. Is it due to drugs—or something else?” Some antidepressants, for example, can cause fatigue and dehydration. “You may think it’s a part of your depression, or just a part of getting older, but it’s not,” says geriatrician Alicia Arbaje, M.D., M.P.H., an internal medicine specialist at Johns Hopkins School of Medicine.
If you’re having symptoms or are just not feeling yourself these days, experts have one strong piece of advice: Consider medications. “Always think of the drug as a potential cause,” says Dr. Steinman. “If you don’t think about it, it won’t be addressed.”
A Growing Problem
As a culture we’re taking more prescription drugs than ever. One in 5 Americans over age 45 has a chronic condition, such as high blood pressure, which often requires daily medications. Among Americans over 60, 76 percent take at least two medications — 37 percent take five or more.
In the United States, it is estimated that from 2007 to 2009, there were 99,628 emergency hospitalizations a year that involved adverse reactions to medications in people 65 and older. Two-thirds of those were due to unintentional overdoses.
Basically, the more medication you take, the more likely it is that you’ll have side effects—or negative interactions between drugs. “About one-third of older adults have an least one medication side effect each year,” says Dr. Steinman. “Ten percent of hospitalizations are due to the side effects of drugs.” Says Dr Arbaje, “The highest risk is for people who are taking nine or more medications,” she says, “or anyone who has six or more chronic illnesses.”
“As people get older and have more medical problems, the number of medications they take can increase quickly,” says Dr. Steinman. Even if you are taking just one or two medications, now is the time to develop the self-protective habits (such as exercising and eating a healthy diet) that can help you prevent future problems — or identify existing ones.
The Problem with Sleeping Pills
Sleep medications, if you take them regularly, often cause problems, says Dr. Arbaje. “Any medication you take that is supposed to make you go to sleep can be a problem in terms of reactions. That includes prescriptions, but also over-the-counter medications, as well as alcohol.” Anti-anxiety medications such as benzodiazepines are commonly used to help people sleep, notes Dr. Steinman, “but they increase the risk of falls, and memory problems.”
"Sometimes people need a pill,” admits Dr. Arbaje. “But the habit often starts when people are younger, in a highly-competitive working environment. But when you keep on for years, even decades, it becomes an issue.” Says Dr. Steinman, “A lot of people take them to sleep at night, but they have a whole host of side effects, which can include confusion, balance issues, and increased urination. You may not even realize you’re having side effects until you stop—and feel better.”
The more medications you take, the more likely they will interact in adverse—and sometimes unpredictable—ways. As you just learned, sleep medications alone can cause problems, but if you’re also taking pain medications, it can get worse. “Both affect thinking and the ability to maneuver in the world,” says Dr. Arbaje. Other problem combos:
The answer isn’t to ditch you meds. It can often be dangerous to simply discontinue a prescription medication. The answer is to talk with your doctors and pharmacist to explore whether a medication, or a combination of them, may be causing you problems.
Do a Medication Checkup
“Schedule a separate appointment with your health care provider just to go over your meds,” advises Dr. Arbaje. “It’s like reviewing your stock portfolio, only with your medication.”
You may find that you are still taking a medication you don’t need, or that switching to a different medication or dose may reduce bothersome side effects. “You don’t want to miss out on medicines that may improve your health, help you feel better, or prevent disease such as heart attacks or strokes,” says Dr. Steinman. “But few people talk with their doctors on a regular basis about each of their drugs. What’s it for? Is it still needed?”
Rely on Your Pharmacist
Often, your pharmacist is the only health professional who sees the whole picture of your medication profile. “Pharmacists play an essential and under-appreciated role in managing medications and well-being,” says Dr. Steinman. “They often have the time and the expertise to review your medications.” Even if you don’t review your whole list, “make sure you ask questions of the pharmacist where you get your meds.” Medicine, he says, “is a team sport.” One tip from Dr. Arbaje: Use one pharmacist, not several. That way your record will all be in one place.
Explore Non-Drug Solutions
“Lifestyle interventions are critically important and often under-used,” says Dr. Steinman. “It’s much easier to take a pill than to change the way you eat, or exercise. And it’s easier for a doctor to prescribe a pill. But there’s so much benefit from changing diet and exercise.” Exercise, for example, lowers blood pressure, helps control weight, improves blood sugar regulation in diabetes, is good for mood, and helps with sleep, he says. “For all these benefits you’d need 6 or 7 pills.”
Dr. Arbaje often addresses sleep issues with her patients. She explains that sleep pills don’t help you function better the next day. “I talk about lifestyle changes. What’s keeping you up at night? If it’s pain, let’s treat the pain.” Simple changes such as getting some exercise at least three hours before bedtime, sticking to a sleep schedule, and staying off distracting electronic screens late at night, can improve sleep, she says. “You create a ritual, a routine, such as a bath or meditation or prayer, to quiet the mind.”
How well do you get along with your grandchild and other family members? Want to know if your personalities mesh?Find out here.