More than 40% of older adults in the U.S. take five or more prescription drugs daily. In South Africa, the numbers are rising fast too-especially in urban areas where chronic conditions like high blood pressure, diabetes, and arthritis are common. But here’s the truth no one talks about: taking more medicine doesn’t always mean better health. Sometimes, it means more falls, more confusion, more hospital visits-and even a higher risk of death.
Why Stopping Medicines Can Be Safer Than Keeping Them
Deprescribing isn’t about cutting corners. It’s about removing drugs that no longer help-or worse, hurt. The term was first coined in 2003 by an Australian doctor who noticed that seniors were drowning in pills they didn’t need. Today, experts agree: if a medication’s risks outweigh its benefits, it’s time to stop.
Think of it like this: you wouldn’t keep wearing a heavy winter coat in summer just because you once needed it. The same logic applies to pills. A statin prescribed at 70 to prevent a heart attack might make no sense at 85 if you’re now frail, living with dementia, and focused on comfort, not longevity. That same statin could be causing muscle pain, memory issues, or even kidney strain.
Studies show that when seniors stop unnecessary medications, they experience 17-30% fewer adverse drug events. Hospital readmissions drop by up to 25%. Quality of life improves. And not one study has shown harm from stopping the right drugs at the right time.
When to Ask: Is This Medicine Still Needed?
Not every pill needs to be taken forever. Here are five clear signs it’s time for a medication review:
- You’ve developed new symptoms-dizziness, confusion, fatigue, nausea, or unexplained bruising. These aren’t just "getting older." They could be side effects. For example, benzodiazepines (like diazepam or lorazepam) for anxiety can cause falls in seniors. Anticholinergics (found in some sleep aids and bladder meds) can fog your thinking.
- You’ve been diagnosed with advanced illness-like late-stage dementia, heart failure, or cancer. Preventive drugs like aspirin for heart disease or vaccines for shingles may no longer matter if your goal is comfort, not prevention. A 90-year-old with dementia doesn’t need a cholesterol-lowering drug that takes months to show benefit.
- You’re on high-risk combinations. Some drugs are dangerous together. For instance, mixing NSAIDs (like ibuprofen) with blood thinners (like warfarin) raises bleeding risk. Taking multiple sleep aids or sedatives can slow breathing. The Beers Criteria and STOPP guidelines list these risky pairings-and doctors should check them every time a prescription is renewed.
- You’re taking preventive meds with no short-term benefit. Statins, osteoporosis drugs, or diabetes pills are meant to prevent problems years down the road. But if life expectancy is limited, these drugs become burdens, not benefits. A 2022 study found that seniors over 80 with limited mobility gained nothing from long-term statin use-but still faced muscle damage and liver stress.
- You’re taking the same drug for 10+ years without a review. Many seniors refill prescriptions automatically. No one checks if the original reason still exists. A blood pressure pill prescribed after a stroke 12 years ago? Maybe your BP is now low. Maybe you’re on a diuretic that’s making you weak. It’s time to reassess.
How Deprescribing Works-Step by Step
Deprescribing isn’t just quitting pills. It’s a careful, step-by-step process. Here’s how it should happen:
- Review all meds together. Don’t look at one drug in isolation. Get a full list-from prescriptions, over-the-counter pills, supplements, and herbal products. Many seniors don’t realize that St. John’s Wort interferes with blood thinners, or that calcium supplements can block thyroid meds.
- Identify the goal. Is the goal to reduce falls? Improve memory? Feel more energy? The reason changes what gets stopped first. If dizziness is the issue, stop sedatives or diuretics before touching heart meds.
- Choose one drug to stop. Never stop more than one at a time. That way, if symptoms change, you know why. For example, if you stop a sleep aid and start sleeping better, you know it was the pill causing the problem.
- Lower the dose slowly. Some drugs, like antidepressants or blood pressure meds, need to be tapered. Stopping suddenly can cause rebound effects-higher blood pressure, anxiety, or seizures.
- Monitor closely. Keep a symptom diary for two to four weeks after stopping. Note changes in mood, energy, balance, appetite, or pain. Share this with your doctor or pharmacist.
- Re-evaluate. If symptoms improve, you’re on the right track. If they return or worsen, talk to your provider. Maybe you need to restart, or maybe another drug is the culprit.
Who Should Lead the Review?
Most seniors don’t know how to ask. That’s why a trained professional should guide this.
Pharmacists are often the best first stop. In Australia and Canada, clinical pharmacists routinely do home-based medication reviews for seniors. They spot duplicates, interactions, and outdated prescriptions. In South Africa, community pharmacies are starting to offer this too-ask if your local pharmacy has a geriatric medication review service.
Geriatricians (doctors who specialize in older adults) are also trained in deprescribing. But not every GP knows how. If your doctor dismisses your concerns with “It’s been fine for years,” ask for a referral to a geriatric clinic or ask for a pharmacist consult.
And don’t forget: family caregivers play a key role. If you’re helping a parent manage meds, keep a written list. Bring it to every appointment. Ask: “Is this still needed? What happens if we stop it?”
Common Myths About Stopping Medicines
Here’s what most people get wrong:
- Myth: “If the doctor prescribed it, it must be necessary.” Truth: Doctors prescribe based on guidelines, not individual needs. A drug approved for 70-year-olds might be harmful for a frail 85-year-old.
- Myth: “Stopping meds will make my condition worse.” Truth: For many drugs-especially those taken for prevention-stopping doesn’t change outcomes. A 2023 study of 1,200 seniors over 80 found no increase in heart attacks or strokes after stopping statins.
- Myth: “I’ve been on this pill too long to quit.” Truth: The body adapts. Withdrawal symptoms are rare with most meds if stopped slowly. And if you feel better afterward, it’s proof the drug wasn’t helping.
- Myth: “I need all these pills to stay alive.” Truth: Most seniors take more than they need. The goal isn’t to cut pills-it’s to cut the ones that don’t serve you.
What Happens When You Don’t Deprescribe?
Ignoring unnecessary meds has real costs:
- More falls. One in three seniors over 65 falls each year. Medications like sedatives, antipsychotics, and diuretics are top contributors.
- More confusion. Anticholinergic burden-the total amount of drugs that block acetylcholine-is linked to faster cognitive decline. Even a few of these pills can make memory worse.
- More hospital visits. In the U.S., $30 billion is spent yearly treating adverse drug reactions in seniors. Many are preventable.
- More pill burden. Taking 10 pills a day is exhausting. It leads to missed doses, confusion, and resentment. Simpler regimens mean better adherence.
And here’s the quiet tragedy: many seniors don’t even know they can ask to stop. They think it’s their job to take everything they’re given. It’s not. You have the right to question every pill.
Where to Start Today
You don’t need a big medical system to begin. Here’s what you can do right now:
- Write down every medication you or your loved one takes-name, dose, why it was prescribed, and how long you’ve been on it.
- Look up the drugs on deprescribing.org. They have free, evidence-based guides for common meds like PPIs (for heartburn), benzodiazepines, and diabetes drugs.
- Book a 20-minute appointment with your pharmacist. Ask: “Can we review these meds? Are any of them no longer needed?”
- If you’re a caregiver, bring the list to the next doctor visit. Say: “We’re thinking about reducing some of these. Can we talk about which ones are safe to stop?”
- Track changes. After stopping one drug, note how you feel for two weeks. Did sleep improve? Did energy rise? Did dizziness go away?
Deprescribing isn’t about giving up. It’s about choosing quality over quantity. It’s about living well, not just living longer.
Can stopping medications cause withdrawal symptoms?
Yes, but only with certain drugs-and only if stopped too quickly. Medications like antidepressants, blood pressure pills, steroids, and some seizure drugs need to be tapered slowly. Stopping them abruptly can cause rebound effects like anxiety, high blood pressure, or seizures. But most common meds-like statins, calcium supplements, or antacids-can be stopped safely without withdrawal. The key is doing it one at a time, under supervision.
What if my doctor says I need all my meds?
Ask why. Say: “I’ve read that some of these might not be helping anymore. Can we look at each one and decide if it’s still right for me?” If your doctor refuses to discuss it, ask for a referral to a geriatrician or clinical pharmacist. You have the right to be involved in decisions about your care. If your doctor dismisses your concerns, it’s time to find someone who listens.
Are over-the-counter pills and supplements included in deprescribing?
Absolutely. Many seniors take daily supplements like calcium, vitamin D, or herbal remedies without realizing they can interact with prescriptions. For example, St. John’s Wort can make blood thinners useless. High-dose vitamin E can increase bleeding risk. Even common painkillers like ibuprofen can raise blood pressure or damage kidneys. Every pill-prescription or not-should be reviewed.
How long does it take to see results after stopping a medication?
It varies. For drugs causing dizziness or confusion, you might feel better in days. For muscle pain from statins, improvement can take 2-4 weeks. For sleep aids, better sleep may come within a week. But some effects take longer-like improved kidney function after stopping NSAIDs. Give it at least two weeks before deciding if the change helped. Keep a journal.
Is deprescribing safe for people with dementia?
Yes-and often essential. Many dementia patients are given antipsychotics to manage agitation, but these drugs increase stroke risk and can speed up cognitive decline. Studies show that carefully stopping these meds improves behavior and reduces sedation. Always work with a specialist. The goal isn’t to stop all meds, but to remove the ones that cause more harm than good.
Can I stop a medication on my own?
Never stop a prescription drug without talking to your doctor or pharmacist first. Some meds are dangerous to quit suddenly. But you can start by asking for a review. Bring your list. Ask questions. Make it clear you want to simplify your regimen. Most providers will support you-if you ask.
Will stopping meds make me more likely to get sick?
No-when done right. Deprescribing targets drugs that offer little benefit and high risk. For example, stopping a daily aspirin in someone over 80 with no heart disease doesn’t increase heart attack risk-it lowers bleeding risk. Stopping a statin in a frail senior doesn’t raise death rates-it reduces side effects. The goal isn’t to stop all meds, but to stop the ones that aren’t helping.
What Comes Next?
If you’ve been taking the same pills for years, it’s time to pause. Don’t wait for a crisis. Don’t assume your doctor will bring it up. Take the list. Walk into your pharmacy. Ask for a review. Talk to your family. You’re not giving up your health-you’re reclaiming it.
Less medicine can mean more life. Not just more years. More energy. More clarity. More days spent enjoying your grandchildren-not counting pills.
