Polypharmacy in the Elderly: Taking Too Many Medications Can Be Risky

Polypharmacy occurs when a patient takes too many medications for their own good. It is most common among seniors and individuals with multiple medical conditions. Since older people metabolize drugs differently, the combined effects of numerous medications can be especially harmful.

What Is Polypharmacy?

Polypharmacy is the simultaneous use of multiple medications. While this may not seem like a bad thing, being on too many medications can lead to potentially dangerous drug interactions and means exposure to many different side effects all at once. This applies not to just prescriptions but also to over-the-counter (OTC) medications and dietary supplements, which patients often use as needed without informing their doctors.

Treating only one chronic medical condition may require several prescriptions, but for seniors who often have several ailments, their medication regimens can be very complex. It can get to the point where the patient does not know all the drugs they are taking, why they are needed, or how to take them properly. Medication errors are more likely with complex regimens and can be dangerous as well. What is worse is that physicians may not be aware of all the medications their patients are taking.

Research shows that the average older adult takes four or more prescription drugs each day, but a whopping 39 percent of seniors take five or more prescriptions each day. While each one was created to treat or manage a specific medical problem, each also comes with its own risks and side effects. The more medications a person takes, the higher the chances are for experiencing adverse reactions, negative side effects and even life-threatening conditions. Overall, polypharmacy in the elderly is a major contributor to disability, frailty, falls, long-term care placement and a decreased quality of life.

Symptoms of Too Many Medications

“Polypharmacy is a huge problem in our society,” says Stephen Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T., internationally renowned cardiologist and author of The Great Cholesterol Myth. According to Dr. Sinatra, elderly patients are often put on five or more medications at once and it’s no surprise that they develop serious side effects. This is especially true for those who have been diagnosed with heart disease or recently suffered a heart attack or stroke.

“Unfortunately, many doctors attribute these side effects to just getting older,” Dr. Sinatra notes, but age isn’t always the culprit.

If a loved one takes multiple prescriptions, OTC medications and/or supplements each day, it’s important to keep an eye out for troubling side effects.

Common Adverse Effects of Multiple Medications

  • Tiredness, sleepiness or decreased alertness
  • Constipation, diarrhea or incontinence
  • Loss of appetite
  • Confusion (either continuous or episodic)
  • Falls and other mobility issues
  • Depression or general lack of interest
  • Weakness
  • Tremors
  • Hallucinations (such as seeing or hearing things)
  • Anxiety or excitability
  • Dizziness
  • Changes in sexual behavior
  • Skin rashes

How to Decrease the Dangers of Polypharmacy

Responsible medication management is the best way to prevent adverse health outcomes related to medication use. A senior and their entire care team must work together toward this goal.

Make a Complete Medication List

The first and most important step is to inform every physician involved in your loved one’s treatment of every medication and supplement your loved one takes. The easiest way to do this is to collect every pill bottle/container and make a detailed account of their medication regimen. The list should include each drug’s name, strength (in milligrams or international units), recommended dosage, instructions (such as frequency and timing), and any cautions stated on the bottle or package.

Retain a copy of this medication list for your own records and provide each of your loved one’s physicians with a copy. Each time a drug is added, removed or changed, be sure to update the document. This tool allows all doctors to get a complete and accurate picture of your loved one’s health and medications before making any treatment decisions. Having a copy on hand in the event of an emergency can be extremely useful for first responders and hospital staff as well.

Read Medication Inserts and Instructions Carefully

Whenever a new drug is prescribed, it is crucial to read the printed medication guide that comes in the package. This insert will provide information about the medicine, how to take it, possible interactions with certain medical conditions, other drugs, and foods, and tips for avoiding adverse effects while taking it.

You can look up a medication package insert using the DailyMed database provided by the National Library of Medicine (NLM).

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