When I was in medical school in the mid-70s we were taught to only give prescriptions to our patients for as short a duration as possible. Drugs provided short-term relief until a patient mustered their own defenses and were not a ‘preventive’ strategy. Now we have patients on ‘just in case’ drugs that should have no place in patient care. This new strategy of prescribing means “Patients Have at Least One Prescription for Longer Than Needed”
One drug given for an inappropriately long time doesn’t sound too bad but when that occurs in HALF of all primary care patients, you’ve got a monumental problem. That’s what this current study found. Millions of people are taking excessive amounts of unnecessary drugs. The most overprescribed drugs include antidepressants, bisphosphonates, or proton pump inhibitors (PPIs).
Over the years, I’ve had a lot to say about these three classes of drugs:
1. Antidepressants, several contain fluoride, which binds with magnesium making it unavailable to the body and causing magnesium deficiency symptoms that include anxiety and depression. And they only work about 30% of the time.
2. Bisphosphonates given for osteoporosis kill the osteoclast cells that help break down and remodel bone. Without osteoclast activity bone becomes misshapen and brittle, leading to more fractures, not less.
3. PPIs have an FDA warning that they cause magnesium deficiency.
I remember my geriatric rotation where I lived in residence and didn’t have much to do when the floors were quiet. So, I began reading through patient’s charts and was shocked to find drugs prescribed with no termination date; drugs for an acute condition that had long passed; and drugs prescribed by various specialists who obviously didn’t look at the whole chart for negative drug interactions. I created a drug page in each chart and made it abundantly clear what drugs a patient was taking and asked the attending doctor to check all the prescribed drugs to see if they were still needed.
As I usually do, I caused quite a stir with my little project, but I did manage to get the patients off a lot of unnecessary drugs!
The article describing this study continued with a lot of hemming and hawing about polypharmacy and advised that improvements should be made but no recommendations were made. Nothing is really going to change because doctors have been trained to rely on drugs and don’t have anything else to offer their patients.
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Carolyn Dean MD ND
The Doctor of the Future®
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