Why doctors sometimes won’t prescribe drugs

medicine pills and water

Strike the right balance. Too much medication can be bad for your health.

by Warren Heggarty

Many of us are on several different medications at once. It is important that we talk regularly about them to our prescribing doctors, dentists or nurses.

Geoffrey had an extremely sore throat and went to his local GP Dr Samir, fully expecting to be prescribed antibiotics. Dr Samir had other ideas however. “I think you have a viral infection,” he said, “so I won’t give you antibiotics now. They won’t do any good. If it doesn’t get better over the next couple of days, come back and see me then.” The throat got better of its own accord without medication.

Later, Geoffrey had severe diarrhoea. This time, Dr Sharon examined him. “Your stomach is very squishy and you look dehydrated,” she said, “You may have a virus. You need to sip several litres of Hydralite to replenish your fluids.’ Again, no actual medicine required and it cleared up on its own.

In fact, antibiotics don’t work at all with many illnesses – and they have side effects. Your GP will decide whether antibiotics are worthwhile, or if in doubt, they will order tests. Some bacteria have actually developed resistance to antibiotics over the years because of overprescribing. However, if you are given antibiotics, you need to take the whole course ordered by the doctor, even after you begin to feel better. Good GPs are nowadays wary about patients demanding certain medicines that may not be appropriate.

According to Professor Kerryn Phelps writing in February 2016 Women’s Weekly “de-prescription” is the new buzz word in GP surgeries because excess medication is a growing threat to the health of Australians. This is especially true of older people.
There are four things that need to watch to make sure you are not overmedicated: the side-effects, the interactions between medicines, whether you still actually need a medicine, and whether you need to review the dose of the medicine.

Geoffrey takes three medications every day. He takes an anti-depressant because it relieves the symptoms of his OCD, plus he takes a combination of two blood pressure medications. For a while recently, he also had to take a painkiller and an antibiotic following a dental infection. That brought him to five pills at once!

A year ago, he discovered his blood pressure was dangerously high. One medication was not enough, but the combination of two took it down to a safe level again. Geoffrey knows what each of his medications does and he is familiar with (and able to tolerate) the side effects. The psychiatrist at Bankstown Hospital told him that it was best to review his anti-depressant dose regularly because lower doses may sometimes be just as effective, while having less side effects. Geoffrey also knows that suddenly stopping can cause withdrawals.

He had been reluctant to take the blood pressure medication because previously he had suffered severe constipation from it. Dr Sharon convinced him that the new formula did not have such bad side effects but in any case, if left untreated he was in danger of having a stroke or heart attack. Fortunately, although he felt a bit light headed to begin with, the combination of the three medications worked well and on subsequent visits to Dr Samir and Dr Sharon he has been in good shape.

Ask your GP these questions about your medications, whatever they are for:

Ask: Why is this medicine necessary?

Ask: Is there any way of achieving this without drugs, for example, diet or lifestyle changes?

Discuss any new symptom that starts after taking medicine. It could be a side effect or interaction.

If you and your doctor decide to discontinue a medicine, discuss it fully. You may need to wean yourself off slowly to avoid withdrawal symptoms.

 

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