Taking multiple medications? You may need to scale back.

About one in five adults ages 40 to 79 takes five or more prescription drugs, according to data from the Centers for Disease Control and Prevention. And the older patients are, the more likely they are to take even more drugs.

But taking many medications at once, known among medical experts as polypharmacy, increases the risk of serious side effects and drug interactions, said Dr. Nina Blachman, associate professor of medicine and geriatrics at the NYU Grossman School of Medicine.

Studies show that taking multiple medications is associated with faster memory decline in some patients with mild cognitive impairment and an increased risk of falls among people with balance problems or weak muscles. And certain drug combinations can lead to excessive bleeding, dangerously low blood sugar, or other serious complications that result in hundreds of older adults being hospitalized every day.

While medications can be critical to improving our quality of life, it’s important to understand how people end up taking too many medications unnecessarily and when to seek help to trim the prescription list.

As people age, they develop more health problems such as diabetes, heart disease, arthritis and high blood pressure, and end up taking more and more medications, Dr. Blachman said. Many are never taken off the drugs they’ve been prescribed for years, even if they no longer need them or newer formulations are available that can treat different symptoms simultaneously.

Patients also sometimes see a variety of medical providers, each of whom may prescribe medications without necessarily communicating with each other.

Sometimes medical professionals may prescribe drugs to treat the side effects of another drug, in what doctors call a prescription cascade. For example, people taking certain over-the-counter pain medications called nonsteroidal anti-inflammatory drugs may experience increased blood pressure, which doctors may misdiagnose as a new condition and prescribe calcium channel blockers as treatment. But in some people, these blood pressure drugs can cause ankle swelling, which may lead to the prescription of a diuretic to reduce fluid build-up in the body.

So you just end up chasing side effects from one drug after another, Dr. Blachman said.

Older patients may also be more likely to develop new or worse side effects from the drugs because kidney and liver function can decline with age, making the body less able to filter out some drugs, said Barbara Farrell, Scientist from the Bruyere Research Institute in Ottawa. . This can lead to patients receiving even more medication to treat these side effects.

Although polypharmacy is more common in older people, younger adults and even children, especially those with complicated chronic conditions such as epilepsy, learning disorders or mental health problems, can also end up taking a lot of medicine.

To further complicate matters, pharmacists and doctors don’t always know how or when to help patients get off drugs safely, Dr. Farrell said. But in recent years, she and other experts have pushed for more guidelines to reduce or stop prescription drugs.

Ideally, doctors and pharmacists should do what’s called medication reconciliation every time you see them, said Kuldip Patel, the associate director of pharmacy at Duke University Hospital in North Carolina. To do this, his team reviews the list of medications that people take whenever they enter or leave the hospital. But that doesn’t always happen in all medical settings, he said.

Experts suggest asking a primary care doctor or pharmacist to do a full medication review at least once a year. Many pharmacies offer these assessments under free medication therapy management programs. Make a list of your medications, including supplements and over-the-counter medications, or take all your pill bottles and bring them with you to your appointment, Dr. Patel said.

But perhaps the best time to talk about using your prescription is before you start a new medication. Ask your doctor questions such as Am I experiencing a symptom that could be a side effect of a medication I am taking? o Can I try to manage this symptom with lifestyle changes first?

When you need a drug, see if you can start at a lower dose, Dr. Farrell said. Remind the doctor about the medications you are taking and ask how the new medication will interact with them.

Finally, ask how long you will need to take a medication and work on a plan with your doctor to stop taking it if necessary. You should understand how your provider plans to help you taper off the medication, what withdrawal symptoms to watch for, and how to make sure the problem you were being treated for doesn’t return.

These are questions people should be asking even in their teens and 20s when starting some of these medications, Dr. Farrell said. Then hopefully one day it can keep people from getting to the point where they’re taking 25 medications all together.

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