It's only fair to share…

There is a steady stream of information coming out about the downsides of medications and particularly long term use of medications. Medicines are trialed over relatively short periods of time but can then be taken for five, ten or even twenty years. Trials done over two years will of course not reveal problems that may only arise after five years of use.

It also looks like this is a problem at any stage of life. Australian research has shown that use of antipsychotic drugs in the over 65s, leads to increased rates of hip fractures and pneumonia within the first 12 weeks of treatment! For every three who got benefit, one got pneumonia. The rates with hip fractures were one in every five to 13 treated. These are very high numbers and it is even worse when one considers that the drugs have a “modest” effect at best in many cases.

At the other end of the spectrum use of antidepressants in pregnancy has been connected with low birth weight in babies. In addition to this there is an increased rate of miscarriage. Back in 2005 the FDA warned about risks of birth defects with some antidepressants.

Another interesting one is that diabetics on long term Metformin are much more likely to be deficient in Vitamin B12 which is one of the key B group vitamins. Whilst it has long been known that regular aspirin increases the risk of stomach ulcers it has now emerged that it may increase the risk of Crohns disease.

To be honest I am a bit doubtful about the last one. However it has long been a lament in primary care to have patients confused after the cardiologist has told them to take aspirin because it is good for the heart and the gastroenterologist has told them to stop it, as it is bad for their stomach. This leads people to ask, and quite reasonably so, what do I do?

Meanwhile an attempt to give elderly people a years worth of Vitamin D in one dose failed to have the desired effect. There was no decrease in fracture rates. Given the active form of Vitamin D is produced in the skin under the influence of sunlight this should not have come as a surprise. Vitamin D is needed daily, not yearly. Doctors and scientists like to think they are smarter than nature. They are not.

The key message in all this is that there is no such thing as free lunch. When it comes to lifestyle conditions, lifestyle changes are side effect free and have other benefits too. Medications will always have side effects even if they take years to appear. There is certainly no case to be made for healthy people to take long term medications of any description. With drugs, like antidepressants we have become to quick to medicate, rather than accept people have down periods and may just need support and a bit of time.

We also need to be very wary of the reclassification of healthy people as having risk factors needing medication. If we have lifestyle risk factors for disease, which relate for example to what we eat, then the solution is to change what we eat. The answer is not in a pill.

Be in charge of your health. Be wary of claims made about the need for long term medication. Be questioning of side effects. Above all else focus on being healthy.