Medications
Five medications or more: why they are worth reviewing
Taking five or more medications a day is called polypharmacy. It is not bad in itself, but past that number the risk of interactions and adverse effects grows markedly.
Dra. Brenda Joanna Estrada Martínez How you end up with fourteen pills
It is almost never one bad decision. It is the sum of many reasonable decisions taken at different moments: a drug for blood pressure, another for pain, one for sleep prescribed "for a few days" three years ago, a stomach protector nobody withdrew.
The problem is that someone rarely reviews the entire list at once, with the person in front of them and all the boxes on the table.
Signs a medication is doing harm
Dizziness on standing, daytime drowsiness, confusion, falls, constipation, urinary retention or loss of appetite. In older adults these symptoms tend to be blamed on age, when many times they are side effects.
A useful rule: if a new symptom appeared in the weeks after a treatment change, the first suspect is the treatment.
What deprescribing is
It is the planned, gradual and monitored withdrawal of a drug that no longer brings benefit, or whose risk outweighs the advantage. It is not "taking medicines away": it is checking that each one has an indication that still holds for this person, today.
It is done slowly, one or two drugs at a time, explaining why and watching the result. Nothing is stopped without a clinical reason or without agreement from the patient and their family.
How to prepare for that visit
The most useful thing you can do is bring everything: prescriptions, boxes, bottles, drops, injections, supplements and herbal remedies. The mental list is almost always incomplete, and what is missing tends to be exactly what interacts.
Dr. Brenda Joanna Estrada Martínez
Geriatrician board certified by the Mexican Council of Geriatrics. She practices in Ciudad Juárez, at the office and at home.
