A life without drugs: Is stopping medication just possible?
Medications can sometimes be described as both saviors and evildoers. Even the well-known "wolf in sheep's clothing" would in some scenarios aptly describe the situation with the prevailing drug administration. The numerous drugs have managed to increase the quality of life enormously and to put an end to partly aggressive diseases. On the other hand, they generate interactions and side effects. There is also the danger that wrong diagnoses lead to wrong pharmaceutical approaches. Especially in older patients, these bad aspects often stick, so that this group of people would prefer to say goodbye to them. But what is the procedure if the results during a medical check-up give positive signals? Is there then anything standing in the way of discontinuation in old age?
Weighing benefits & risks in a targeted manner
Even for physicians, the answer to this previously mentioned question is not always directly tangible. Rather, it is a matter of including the medication list and looking together at how the intake schedule is made up. After the detailed assessment and evaluation, the physician can decide which medications are still necessary and which can be discontinued under supervision. The importance of this procedure can be deduced from the opinion of many physicians. For example, the majority of them consider it important, especially in advanced age, to evaluate this medication plan at least once a year and, of course, to question it critically. If this directional plan is not directly accessible, the regular pharmacy can provide a very precise remedy. Here, the accumulated medication expenditures of the past can be quickly overviewed and printed out.
Discontinuing medication in old age due to polymedication
So-called polymedication also harbors dangers. If many drugs are taken at the same time, an automatically higher mode of action cannot be expected. Rather, there is a risk that the different drugs will "bite" each other. This means that side effects can occur, or that interactions can occur. The degradation of a drug can also be impaired by another drug, which in turn can increase the mode of action.
Also due to this situation, it is advantageous to talk to the attending physician about possibly discontinuing certain medications. An alternative can promise success here. Many alternatives have the same effect, but cause fewer problems in combination with the others. Here, the professional involvement of the doctor is usually worth its weight in gold for the patient's own well-being.
The following symptoms can often be attributed to a drug side effect or interaction:
- Dizziness
- Drowsiness
- Confused phases
- Falls
- Dryness of the mouth
- Nausea or vomiting
- Creek pain
- Constipation
- Problems with sleeping
Medications that must not be simply discontinued
While there is room for improvement with many drugs and the need for them can be viewed critically after a certain period of use, there are also some that are not easily dispensable. Here, discontinuation too quickly would lead to complications and sometimes even life-threatening situations. Older people in particular must exercise caution here and have the whole thing approved by a specialist. Proceeding "on your own" is often fatal.
In particular, the following medications should not be discontinued directly in old age:
- Beta-blockers
- Acid blockers
- Antidepressants
- Hormone drugs
- Cortisone
- Nasal spray
Beta-blocker
Beta-blockers, as the antihypertensive drugs are called, efficiently lower elevated blood pressure to a normal range. Above all, because this success is achieved very quickly after starting to take the medication, many older patients then want to stop taking it again. "Everything seems to be fine now," they often say, without considering the consequences of stopping the medication. However, only very few people are aware that this procedure actually worsens the overall situation. Without the medication, blood pressure can rise to such a high level that, in the worst case, a stroke is imminent. Since constant beta-blocker use leads to a decrease in the receptors that keep blood pressure down, there is a risk that normal regulation will no longer take place. In the worst case, this leads to the stroke described.
Acid Blocker
Proton pump inhibitors, also known as acid blockers, are usually taken for a short time when heartburn occurs. Particularly in the case of people who suffer from heartburn on a permanent basis, there is a risk that the duration of intake is rushed up. The critical limit of 4 weeks at a time is exceeded when taking the medication, and only very few people know that this can have very serious consequences. What follows is often referred to in technical jargon as the "re-bound effect" and describes what is caused after such an abrupt discontinuation. In most cases, gastric acidosis is even worse afterwards. Continuous use has made the problem worse than it was before.
Antidepressiva
Depressive episodes are not uncommon, especially in old age. The use of antidepressants is a successful way of relieving the psychological pressure of older patients. The successes occur quickly and allow those affected to "breathe easy" again after just a few weeks. However, it is precisely this rapid improvement that harbors dangers, since many now believe that they can do without the medication. However, premature discontinuation usually causes a relentless relapse into the old depressive mood. In addition, the problem arises that when the medication is taken again later, it no longer has the full effect. Here it is important to discuss a reduction with the doctor you trust and to involve him or her. Only he can judge whether this plan is justifiable and whether there are no foreseeable dangers.
Hormone drugs
Hormone drugs can successfully improve mood before the onset of menopausal symptoms. However, many do not see that this hormone replacement therapy is also quite criticized by many doctors. After discontinuation, taking the medication can be associated with downright withdrawal. Since body and mind are equally affected by the effect of the drug, "withdrawal" is not uncommon here. Together with the doctor, a gentler approach should be taken here. Slowly discontinuing the drug under medical supervision ensures that the worst-case scenario described above does not occur.
Kortison
When taken for more than 14 days, cortisone reduces the cortisone balance in the adrenal glands. As a result, the hormone is produced less, or in the worst case not at all, during the intake. The body is overwhelmed if you abruptly stop at this point. Severe nausea and also metabolic derailments can be the result. Here, too, the only health-preserving option is to discontinue the drug slowly together with the doctor.
Nasal spray
Nasal spray seems harmless at first, but the decongestant variants in particular harbor a hidden potential for addiction. Already with an application over 5 days, the body can get used to the agent. As a result, many sufferers no longer breathe properly without the nasal spray and have to use it every 2 hours or so. Here, too, slowly discontinuing use together with the doctor is the only sensible way of slowly freeing oneself from its clutches.
Conclusion
Discontinuation of medication is advised in some cases. However, in other cases it can be life-threatening. Despite all the criticism of the pharmaceutical industry and doctors who are now more courageous in prescribing medications, many things save people's lives. If you are affected and are considering stopping medication, the only right step for you is to go to your trusted doctor.
