What is Polypharmacy and is it killing you ?

Polypharmacy. A Modern Epidemic.

If you google the keywords, taking too many medications, chances are you will come across a term called polypharmacy. The word has been used for a long time to describe the problem of patients taking multiple medications. Although the elderly are most likely to “suffer” from polypharmacy, people with psychiatric  conditions and many other chronic conditions can also be placed on a lot of medications.

Only recently the medical community has started to pay a lot of attention to the many downsides or risks to patients on multiple medications. Unfortunately physicians recognize polypharmacy as a problem, but tend not to do anything about it.

Although there is no single definition, polypharmacy is often described as someone taking 5 or more medications on a daily basis. 

To be honest, I don’t find definitions using a specific number or amount very helpful. Four medications for one person could be harmful, while seven medications for another person may be safe and effective. So it all depends …

Although there is no precise definition, I would argue that as patients and caregivers, you “know it” when you experience it firsthand. You don’t need a precise number of medications or pills to tell you that. 

You know in your head and heart when a loved one is taking too many medications. 

The real problem is that you don’t know quite what to do about that nagging sense of doubt or worry about someone taking too many medications. I bet that it was that nagging sense that something wasn’t quite right that led you to find my blog in the first place. 

I promise you that there is a lot you can do to “treat” this condition of taking too many medications.. Simplifying (and that usually means reducing) a loved one’s medications is not only life-saving, it is something you must do. My purpose in writing this blog is to show you how.

I am often asked if I am against prescription medication in general. For those of you who know me and who have been my patient, you know I am not against medication. I trained as an internal medicine physician and have relied on medications  to treat many serious and not so serious illnesses and conditions. 

Medications can be incredibly important - even life-saving. 

Antibiotics, for example, saves lives. Treating high blood pressure with any number of medications will prevent a stroke or heart attack. Taking multiple medications has changed the face of HIV from a universally fatal illness to one of a chronic disease that can be managed. Insulin has turned Type 1 diabetes from an often fatal illness to a readily managed condition.

So my concern isn’t with the use of medication to treat a specific disease or condition. My concern is when someone is prescribed multiple medications to treat multiple conditions and doesn’t consider the consequences.

To make matters worse, medications are not stopped even though the condition may no longer exist or the medication is no longer needed. 

And of course there is the concern that some medications cause side effects leading to the treatment of these new side effects with even more medication. (This is called the prescribing cascade.)

I am reminded of a TV ad during a nightly news broadcast noting that “many medicines can lead to dry mouth”. The ad went on to promote an expensive new medication to treat dry mouth rather than suggest you may want to talk to your doctors to find out which medicines are causing the dry mouth. (Many antidepressants, and some allergy and sleep medicines can cause dry mouth.)

How crazy is that. Even our pharmaceutical companies advocate or accept the prescribing cascade as part of practice - and on prime time television!

The medical profession is well trained in the principles of prescribing medication. We receive no training in how to safely taper and stop medication. A relatively new term has appeared which refers to the process of stopping medication. The new term is deprescribing. I will talk lots more about that in future posts. 

Do you know someone who is suffering from the condition of polypharmacy? What has been your experience? Your story and how you found a solution can do so much to help others as they face similar challenges. We are all in this together.

My warmest regards,

Dr. Marie