Physicians, pharmacists and pharmaceutical companies complain bitterly that patients don’t take their medicine. Health professionals wring their hands and gnash their teeth over what they call the compliance crisis. Actually, they have changed the name because of a recognition that this term sounds a little condescending. They now refer to it as the adherence problem. It still has a certain amount of finger wagging attached because patients are not following doctors’ orders.
What it boils down to is that a lot of patients either do not fill their prescriptions in the first place or they stop refilling them and cease taking their medicine. A great deal of attention has been devoted to trying to “improve patient adherence.” Prescribers sincerely believe that if they could just get people to swallow their pills as directed there would be fewer medical misadventures. The National Council on Patient Information and Education summarized it this way:
“Lack of medication adherence is America’s other drug problem and leads to unnecessary disease progression, disease complications, reduced functional abilities, a lower quality of life, and even death.”
What has been missing from this decades-long debate is the question why don’t patients take their pills? Most people do not want to suffer or end up in an early grave. Health care professionals and drug companies have seemingly ignored their own responsibility in this discussion. One of the major reasons people are reluctant to swallow prescribed drugs is a lack of trust.
SIDE EFFECTS • SIDE EFFECTS • SIDE EFFECTS!
Not uncommonly health care professionals try to put a positive spin on the drugs they tell patients to take. Prescribers may not mention some of the most common or worrisome complications for fear they might discourage a patient from taking what is perceived as needed medicine. But pretending a medication doesn’t cause side effects doesn’t make it so. When people feel bad because of their medicine, they frequently let their doctors know or they just stop the medicine. If the doctor denies that the medicine is responsible it sets up a conflict and leads to distrust.
At the bottom of this blog we have shared stories from visitors to this website about the frustration people feel when their complaints are disregarded or dismissed. But there is another far more significant reason for the lack of trust. It has to do with the dark side of medicine. It is a secret that patients have figured out on their own. Physicians and pharmacists rarely know about the long-term negative consequences of the medicines they prescribe and dispense. That’s because the FDA rarely requires such prolonged testing. As a result, we have learned some devastating lessons over the decades and people realize that there have been far too many unpleasant surprises like those described below.
THE LONG-TERM UNEXPECTED COMPLICATIONS OF MEDICATIONS
• Hormone Replacement Therapy (HRT)
Premarin (conjugated estrogens) has been prescribed since the early 1940s. For years it was one of the best selling drugs in America. Tens of millions of women have taken Premarin, Prempro (estrogen and progestin) or some other hormone replacement therapy over the last 60 years. These drugs were prescribed for a variety of menopausal symptoms. Hormone enthusiasts also touted them to relieve anxiety, slow the aging process, build stronger bones and reduce the risk of heart attacks.
It wasn’t until 2002 that the Women’s Health Initiative (WHI) study revealed that HRT was likely to increase the risk of heart attacks, strokes and cancer. In 2012 data analyzed from the Nurses Health Study involving 60,000 women were reported. Those women who took both estrogen and progestin for over 10 years had an 88 percent greater likelihood of being diagnosed with breast cancer. Is it any wonder that women would feel angry and betrayed that it took more than 60 years for doctors to discover such serious complications from medicine that was prescribed so routinely to so many?
• Tranquilizers/anti-anxiety agents/sleeping pills
Another perennial pharmaceutical best seller is diazepam (Valium). It was first marketed in 1963 and went on to become the number one most prescribed drug in America. Like its chemical cousin Librium (chlordiazepoxide), which was introduced in 1960, Valium belongs to a class of drugs called benzodiazepines (benzos for short). These anti-anxiety agents, (also called anxiolytics, minor tranquilizers and hypnotics) were prescribed to tens of millions of people to take the edge off the stresses of daily living, calm jittery nerves and relieve insomnia. The success of Librium and Valium has led to other such drugs including Ativan (lorazepam), Dalmane (flurazepam), Klonopin (clonazepam), Halcion (triazolam), Restoril (temezepam), Serax (oxazepam) and Xanax (alprazolam).
What doctors did not tell patients, however, was that stopping such drugs could lead to unpleasant withdrawal symptoms. When patients complained that discontinuing a benzo led to anxiety, irritability, panic, insomnia, muscle twitches, sweating and depression, they were often told this was just their underlying anxiety coming back. Go back on the Xanax or Valium and don’t worry about it. Of course we now know that withdrawal is a common feature of benzos and there are no clear guidelines about how to phase off such drugs gradually. Even more worrisome is a recent report from France suggesting that long-term exposure to benzos may increase the risk for dementia. It has taken more than 40 years to learn about this potentially devastating consequence. Again, is it any wonder Americans are distrustful about long-term complications of medications?
• Arthritis drugs/pain relievers
Patients with arthritis have a lot of reasons to be distrustful. In the 1950s they were told that there was a miracle medicine called cortisone that would ease their aching joints almost like magic. What they weren’t told till yeas later was that long-term use of corticosteroids like cortisone, dexamethasone, prednisolone and prednisone could lead to cataracts, glaucoma, high blood pressure, stomach ulcers, blood clots, osteoporosis, muscle weakness and diabetes.
When nonsteroidal anti-inflammatory drugs (NSAIDs) were introduced in the mid sixties they were perceived as much safer than “steroids” like prednisone. Indocin (indomethacin) was followed by drugs like Clinoril (sulindac), Feldene (piroxicam), Motrin (ibuprofen), Naprosyn (naproxen) and Voltaren (diclofenac). Each of these prescription medications was hugely popular until the next NSAID was marketed. Although doctors warned patients about the possibility of stomach upset or ulcers, they frequently presented these medications as quite safe. The FDA agreed and approved ibuprofen for over-the-counter sale in 1984 as Advil and naproxen as Aleve a decade later. It wasn’t until the Vioxx scandal in 2004 that people began to realize that NSAIDs might also cause heart attacks and strokes.
Vioxx (rofecoxib) was approved in 1999 with much fanfare. It was supposed to ease pain and inflammation without the stomach upset associated with other NSAIDs. By the time it was pulled from the market, tens of millions of people had taken the drug worldwide. No one knows how many people suffered heart attacks as a result of taking Vioxx, but the experts have estimated that tens of thousands were harmed.
A recent study from Denmark suggests that virtually all NSAIDs including Celebrex (celecoxib), ibuprofen and diclofenac (Cataflam, Voltaren) can increase the risk for heart attacks in patients who have already had one such cardiac event. Other studies have suggested that even people who have not had a heart attack may be vulnerable to cardiovascular complications including an irregular heart rhythm called atrial fibrillation (A-fib). No one knows how many people may have suffered a heart attack or a stroke because of an NSAID-type drug. Is it any wonder that patients might not want to take their prescribed pain reliever for weeks, months or years, even though their knees, hips and elbows are hurting?
• Other drug disasters
By now you are probably getting the picture. The diabetes drug Avandia was supposed to protect people from heart attacks. Instead it caused them. Over the last several decades there have been a number of diabetes drugs (Rezulin, for example) that have been removed from pharmacy shelves because of unexpected complications. Actos is still on the market in the U.S. but it has been banned in France and Germany because of a link to bladder cancer. No wonder people worry about the long-term effects of their medications.
After tens of millions of people were put on statin-type cholesterol-lowering drugs, we learned that these medications could increase the risk for diabetes and cataracts. It took decades for these and other serious side effects to be acknowledged. We could mention sexual dysfunction from antidepressants along with the unpleasant withdrawal symptoms such drugs can trigger if stopped suddenly. But by now you are doubtless either bored or convinced that doctors often do not know about the long-term complications of the medicines they prescribe.
Poor adherence may have a lot less to do with uncooperative, lazy, unmotivated patients and a lot more to do with distrust of drugs. Physicians are going to have to demand better data from drug companies and the FDA if they plan to convince patients that the medicines which are supposed to be helping are not going to cause unexpected harm down the road.
STORIES FROM PATIENTS:
“I wanted to share with you my sister’s experience with Lipitor. She is 81. Some time ago her doctor prescribed Lipitor for cholestoral control. Soon after, it seems, she began to lose her balance and fell several times, eventually breaking her ankle. She is now confined exclusively to a wheelchair. The closeness of her initial taking Lipitor and her consequent loss of walking is worrisome.”
Don
++++++++++++++++++++++++++++

“ZOLOFT! Never believe anyone who says this drug is NOT addicting. I have been on this drug for 9 years. I have experienced a sexual side effect, little to no sex drive, since first going on this medication. I decided to quit taking it, being told again, it was not addicting. That fact, in my opinion, is false.
“Zoloft may not be addicting like a narcotic, but it IS addicting. After one day of not taking this drug I experienced a dizziness unlike any ever in my life. I felt as though my head weighed 100 pounds and made the muscles in my neck strain to hold it on. I could not walk across a room without holding onto a piece of furniture for stability. My blood pressure shot up to 190/105 and my pulse rate was 165. I was clammy, cold, and incoherent. My daughter, who works in the medical field, came to my house after a frantic call from me requesting medical attention. She took my blood pressure, pulse, and rushed me to the nearest ER. At the ER I was treated for a silent heart attack as those were the symptoms shown. After all seven hours in the ER, all tests returned unfounded. They could not find anything wrong with me. The following morning I woke with a pounding headache. My heart rate was still higher than normal and I was still very dizzy. By day three I felt total despair. I was continually light-headed with a pounding headache. I stayed in bed the following day due to the fact that I could not bear the pain in my head or the dizziness. On the sixth day my daughter called me and asked if I had stopped taking my Zoloft? I told her yes, it had been 6 days. She demanded I take it immediately and call my doctor in the morning. She told me she was sure my illness was a direct effect of not taking the Zoloft. I was going through a physical withdrawal.
“I did take the Zoloft 100 mg, and by morning, most of the symptoms were gone. By day two I was back to my self. All symptoms were gone. I get angry every time someone states Zoloft is NOT addictive. YES IT IS! Please read everything you can before ever stating this drug. It does work wonders for depression and panic attacks. But unless you are willing to take this drug for the rest of your life, do not start taking it.”

Sharon
++++++++++++++++++++++++++++

“Seroquel left me vegetative for a short time. I was not warned about the bizarre side effects. I can’t remember much of what happened, obviously!
“

Why don’t doctors take their patients’ concerns seriously? Why do you suppose so many of us go to the health food store for supplements instead of to the doctor?”

BB
++++++++++++++++++++++++++++
“I was given erythromycin for an infection and immediately started have heart palpitations and shortness of breath. My doctor didn’t believe that it could be that drug, so he gave me something generic but still in the same family as erythromycin. I had the same reaction.
“A couple of years ago I found something on the AMA website stating that erythromycin had been responsible for several cardiac deaths!”

Jean
++++++++++++++++++++++++++++
“I have for a long time thought that the medications I am currently taking was making my joints ache. I take metoprolol and lisinopril-hctz. I have been told that my coughing is a medicine cough but my physician has done nothing about it. She told me the medicine she has prescribed for me is doing a good job 
keeping my blood pressure down and she will not change it. She says, ‘Don’t mess with a good thing’.
“In the meantime, I am aching all over, can barely get around from pain in every joint, but when I complain she just ignores me and says it is arthritis. Then I read that the lisinopril might be causing my hacking cough and the metoprolol could be the reason that I ache so much. I will have a serious talk with my current physician next week or switch doctors.
“I want to get back to my old self again. Doctors aren’t gods even though they think they are. I used to be very active and now I am like an invalid in my own world.”

PEOPLE’S PHARMACY CAUTION: Although beta blockers like atenolol, metoprolol and propranolol have been linked to arthritis pain in some people, such drugs CANNOT be stopped suddenly. A withdrawal effect may precipitate chest pain or even a heart attack. Please do discuss this with your physician. If your doctor prescribed metoprolol for high blood pressure, there may be other options. And there certainly are other ways to control hypertension besides lisinopril. This ACE inhibitor can cause an intractable cough and the only way to solve this problem is to change to another kind of blood pressure medication with your doctor’s supervision. You should not have to be an invalid in your own home.
++++++++++++++++++++++++++++

“My 81 year old father is fighting for his life after being on amiodarone for 3 weeks. He has been in the ICU for 6 weeks with pulmonary fibrosis. The doctors keep calling it idiopathic fibrosis because they do not want to admit amiodarone caused this illness.
“He was healthy, active, had never been on medication before. His cardiologist gave him no alternate choice, sent him home with a bottle of pills, and never shared the warnings of side effects. What benefit do they receive from not blaming this medicine? If he had not taken it, he would be playing golf today.”

Sherry
++++++++++++++++++++++++++++
Share your story below in the comment section of this blog. Let us know your thoughts about the “adherence crisis” in America. We would like to share your thoughts with health professionals who believe that if they just come up with the right strategy they can get people to take their pills on time and renew their prescriptions every month like clock work.

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  1. Cole
    Reply

    Some years ago, I bruised the top part of one foot. I was told nothing was broken; it would heal with time, which it did. The M.D. then wrote a prescription for Valium. I asked: “What’s this for? Are you trying to send me to the Betty Ford Clinic?” He replied: “Who’s Betty Ford?”
    A few years ago, an arm injury sent me to the hospital. A nurse insisted I take a PPI. “Why?” “It’s for acid reflux.” “I don’t have acid reflux.” “But you will.” I was given an Rx, which they insisted I get filled; I didn’t. I could go on with more stories but I won’t.
    The government wants to computerize medical records; they should computerize PRESCRIPTION records, a web site where one could input a doctor’s name, find out what Rx he/she is cranking out as well as his/her ties to the respective drug maker. An earlier commenter suggested we follow the money; such a web site would help. We live in the Age of Pharmageddon.

  2. GW, PhD
    Reply

    I am a social and clinical psychologist involved in both research and therapy, and a former medical school dept chair. In the research literature, by far the strongest predictors of patients not taking their medication is (1) The fact most doctors take an expert position rather than educating patients about the whys and wherefores of the medication, (2) lack of follow-up by doctors, part of the huge problem in the USA of lack of integrated care, (3) doctors’ use of technical language, (4)side-effects of medication, especially if the patient has not been adequately educated by medical staff and explored the cost/benefit ratio of side effects vs. positive effects of medication, (5) Cost of medication, leading some patients to cut back, and (6) patient beliefs about the causes of their illness and their ability to detect improvement.
    The classic is high blood pressure: Most clients think it is caused by stress and they can tell if their blood pressure is high (true for only a small minority.) So if not stressed, some patients go off medication thinking it is not necessary. And research suggests most patients on high blood pressure medication have little idea about what it actually is. Again, this is in part a failure of doctor – patient communication.

  3. Pat
    Reply

    I am a 60 year old female. I’ve been relatively healthy my whole life. One day, three years ago, I “passed out” while with friends. An ambulance was called and I was taken to a local hospital. Turns out a CAT scan found a tumor on my brain, and an MRI the next day confirmed meningioma. Since it was benign, surgery was scheduled for 6 weeks later.
    In the meantime, Keppra, an anti-seizure med, was prescribed for me. After my surgery, when I began to feel better, I decided I didn’t need Keppra anymore. Sure enough, a few months later, I had another seizure, another trip to the hospital. Now I have a love/hate relationship with Keppra. I hate taking it because I’m convinced it makes me tired, reclusive, and overweight, whereas previously I had been active, outgoing, and in good shape. But it’s saving my life and I don’t know if there’s an alternative substance which will prevent seizures.
    Of course I followup with my neurologist several times a year. I learned there are some meds you just shouldn’t stop taking as prescribed.

  4. Ron
    Reply

    First thank you for this site. I took triazolam (halcion) years ago and for only a week or so and found the effects long lasting and terrible. Then I got prescribed Vioxx (sp?) for something about ten years ago but never liked it so hardly took any of that either.
    Now, I always research prescriptions on the internet before even buying them. Came back from the dentist this afternoon with a prescription for Clindamycin, but after reading comments on this site and others I will never buy it. Maybe eat some garlic and have some grapefruit, but the horror stories I read about Clindamycin make it unacceptable to try.
    Also from the dentist I got this horrible chemical taste in my mouth. Rinsed for an hour straight using water, baking soda mixed with water, tomato juice, more water – nothing worked – hope it goes away soon. I read that it comes about from the amalgam in fillings or from the cement used to put on crowns if it is past its date or not mixed properly. NEVER had this bad a chemical taste in all my 58 years. If it doesn’t go away I will complain to whatever dental assn there is. Paid 350 bucks for 45 minutes work, not going to live with this for the next six months.

  5. fbl
    Reply

    Many years ago I did volunteer work with SHIP, a Medicare counseling program. I’m a disabled insurance professional so I did all my work via the phone from home.
    It amazed me how many drugs seniors were taking. One day I was given a very long list and thought that some of these things might be counter productive. I looked a few up on the internet. I was right, so called my local pharmacy and the pharmacist was very patient and helpful. He told me what to say to the lady when I called her back.
    Unfortunately many of the people I talked to had similar problems. Over medicating is rampant.
    These last few years I have been going through the same experience where Drs. keep prescribing different things. Atrial Fibrillation and Tachycardia are very scary so at first I went along with the meds, until each one caused some serious problems. The last drug I stopped was New Year’s eve and I’m still having serious problems from the blood thinner Xarelto. Very weak, achy and painful muscles. The sharp stabbing pains and wasting stopped as soon as I stopped the drug. Yes, I did call the pharmacy to make sure I wouldn’t have a serious hiccup by stopping it cold turkey.
    The irony of the whole blood thinning experience is that my family Dr. said that I didn’t need them. He worked on a skin spot and I bled freely. I told him that the the test said otherwise. He said other tests would have shown differently. He approved of my taking the nattokinase.
    In the meantime my cardiologist was not happy with me. I refused even baby aspirin. The cardioversion worked and my heart rate is good and the EKG beautiful-no more A-fibs!

  6. JR
    Reply

    This is a wonderful, enlightening article. But it leaves me feeling somewhat helpless and a victim. Yes! Not swallowing our pills does come from a lack of trust in the drug companies and the doctor. I, personally, am convinced that the heads of drug companies put the emphasis on the dollar, though many in the company feel their work serves humanity well.
    They are right and they are wrong. My experience is that most doctors, especially young ones, really try. True, they don’t have enough time–or make time–to spend with patients to make an informed, intelligent diagnosis. They seem to see the body as a machine rather than unbelievably complex biological system. And, most of them are not well informed concerning the side effects of drugs. Their training equips them to practice “Internal Medicine.” Most medicine is used internally. And their focus seems to be on which drug to give.
    I realize the potentially horrible dangers of drugs. I suppose there are times when drugs are needed and do more good than harm. But how does one make a sensible decision? Reseach is inadequate, especially long term research. I am told that the FDA is greatly influenced by Pharmaceutical Companies. I have no way of knowing if this is true. I do know, through experience, that supplements, food, sunshine, and exercise and, especially, mental and emotional health play a big part in good health.
    I have lived a long time and this is the first time in history that a multitude of drugs have been used in the name of helping people. I know they can save lives, but I also know of the agony some of them can cause. We must live with the fact that we have many drug resources and have but a vague idea as to how to use them.

  7. Cindy B.
    Reply

    Wow, what a comment thread! I so appreciate it.
    I have always lived very naturally. I use only vinegar to clean with. I don’t eat food with any chemical additives of any kind…. and so on.
    One main reason I don’t trust doctors’ Rx recommendations is that they NEVER seem to have a handle on any more natural ways of treating the problem in question — even though practically every problem can be treated naturally, and in many cases the natural remedy works better. 6 months ago I was Dx’ed with Atrial Fibrillation and was put on 2 Rx meds, Coumadin and Sotolol (a beta-blocker).
    I saw MANY fancy heart docs, and not one of them told me about magnesium. But magnesium, it turns out, is a well known heartbeat regulator. My Afib continued unabated (while on the Rx meds) until I added magnesium on my own. NOW, it’s returned to regular rate and rhythm x 3 months so far. I’m off the coumadin and am gonna try to taper off the Sotalol pretty soon. I also found, through careful trial-and-error, that ginseng was a major factor causing the Afib. No doc told me that either. Most docs haven’t the time or energy to keep up on natural interventions; and they probably feel that giving advice in that arena would mean a greater chance of being sued if the remedy isn’t successful.
    IMHO, if you want the job done right: study, study, study up on your situation — and then treat it yourself if possible. With the help of Peoples Pharmacy of course.

  8. MPR
    Reply

    Most of the “adherence” problems arise from lack of adequate information given to the patient by the doctor. These might include the correct time of day to take a single dose regimen, other drug conflicts, instructions on what to do if perceived side effects appear, etc.. Equally important is information and explicit instructions for drug withdrawals. Withdrawals from Benzodiazopenes (Valium, Xanax,Clonipin), anti depressives (Effexxor, Prozac, etc), Statins, require a measured withdrawal dosage regimen and clear explanations of what the patient can expect withdrawal symptoms to be.
    If the patient is aware of those symptoms, they then have an excellent chance of successfully completing the withdrawal program successfully. It requires a constant communication with patient, physician (or in absence of latter) or pharmacist.

  9. Dean
    Reply

    Over the years, I’ve learned that in order to find answers to questions in areas in which I’m not an expert… I follow the money. For instance, look into the change in recommended total cholesterol levels. About 4 or 5 years ago, the target max was 220. Then it was dropped to 200. The chairperson of the committee making the new lower recommendation was serving on the advisory boards of, I believe, 5 companies either with statins in the marketplace or about to be released.
    NPR did great story on it. I ran worksite wellness program back in the 1980’s for Fortune 500 company, so I speak from that prospective. You want answers on why we are over prescribed…follow the money.

  10. betty
    Reply

    I found this interesting. Moved, so new doctor. I have off and on high blood pressure, and usually at the clinic it is okay, but last time it was elevated to the 150’s over 80’s or something. Doctor said this in his own words.” I can give you ___x__ prescription but it has such and such side effect, so I can give you _x_ to counteract that. But sometimes there is a reaction to that, too, so I can give you a 3rd medication to counter act even that.” I just stared at him and thought to myself “just try it, buddy.”

  11. Penny H.
    Reply

    Last week I visited my internist and was all gung-ho to get off of some of the 21 medicines I take. Fourteen are prescription and the rest OTC medicines that my doctors have known I was taking for years. My internist said no and added another OTC. Meanwhile, I have serious dizzy spells and am unable to walk without a walker.
    I’ve recently tried to eliminate drugs on my own that are addictive such as omeprozole and hydrocodone. I was able to stop the hydrocodone for a fairly long period but had to re-start it because of arthritis and leg pains. When I tried to stop omeprozole I had severe stomach pain and heartburn.
    I do believe that doctors get kickbacks for prescribing “new” drugs and do so before they are adequately tested. I quit one doctor, in part, because he prescribed a Trilipix which was very new, very expensive and caused peeling skin among other symptoms.
    Now I look up every new drug to check out side effects. I also looked up my old medicines and almost all of them cause dizziness, fatigue and drowsiness. What’s a woman to do?

  12. Steve
    Reply

    The terms “adherence” and “compliance” conceal clever marketing strategies by the drug companies. We don’t see the drug companies complaining that patients don’t “adhere to” or “comply with” diets or exercise programs that significantly lessen the need for drugs for hypertension, elevated cholesterol, elevated blood sugar (type 2 diabetes), obesity, etc. The big drugstore chains bemoan the fact that customers don’t “adhere to” or “comply with” doctors’ prescriptions. Why? Because drugstores obviously make less money when customers don’t fill or refill prescriptions.
    The big drugstore chains admit that the cost of prescription drugs can be a burden to many people. The chains use this as an excuse to push more generic drugs. Generic drugs have a better profit margin than brand name drugs. Bemoaning a lack of “adherence” and “compliance” is largely a clever way to sell more drugs. The drug companies should instead bemoan the lack of adherence to or compliance with preventive strategies that might lessen the need for so many drugs in the first place. But that will never happen as long as the pill business is so profitable.

  13. JOAN H.
    Reply

    I have been taking Norvasc several years for high blood pressure. Recently, my doctor, pharmacist, and insurance company encouraged me to switch to the generic, Amlodipine, because of the cost. Norvasc is $116.00 per month vs Amlodipine at $12.00 for three months. They each told me that generics have the same ingredients and I would not have any different side effects. WRONG!
    After I take Amlodipine my pressure drops quickly, I sweat, and my heart rate increases, until the medication starts to wear off. I am deeply concerned about the quality of generics, whether they are being regulated and the fact that they are manufactured in China and India. This is why I am trying to eat healthy, exercise and do everything as natural as possible. I am a 74 year old woman who hopes that I do not have to take a lot of medications in the future.

  14. RC1956
    Reply

    I was placed on Diovan 80 mgs. after Vasatec caused a violent cough. After almost a year on the Diovan, my blood pressure went down to 66/37 with a heart rate of 100. I was so dizzy I had trouble walking, holding onto something. I called my doctor, who said to stop the Diovan and see her. She said to reduce the Diovan to 40 mgs. After some time, my blood pressure was still low in the 100’s over 70s. The options were to stop the Diovan or reduce it to 20 mgs. I took 20 mgs. for a few days and still felt bad. I quite the Diovan then entirely. No withdrawal symptoms I guess because we decreased it gradually. So far my BP has caused any problems staying in the normal range.
    My blood pressure initially went up accompanying a severe headache, neck ache, shoulder ache, upper arm pain, that was thought to be due to stress. I was on Fiorcet prn for six months when my doctor decided to run a MRI, which showed moderate degeneration of the left cervical discs, mild bulging of 5 cervical discs on the left, mild degeneration of the right cervical discs, and a non union of the poster of C1. So the treatment changed with physical therapy and chiropractic which has helped some.
    The blood pressure was subsequently thought to be a consequence of the neck problems and nor a primary BP problem.

  15. Dr Judi
    Reply

    There is another valid reason for not discussing the side effects of a medicine. Just as it is possible for a patient to have a placebo effect, i. e. he feels better because he expected to feel better, so it is possible for him or her to have a nocebo effect, i. e. he has a psychologically induced side/harmful effect.
    I explain these two possibilities to my patients, and I ask them to please let me know if they have any side effects, so we can try and see if it is a pharmacological or a nocebo effect.

  16. betty
    Reply

    I walked into a doctor’s office and said “I have this pain in my … …” and he instantly picked up his prescription pad and made movements to write on it. I stared at his unbelievable action. I wanted to know WHY I have this pain and what can I do to make it not be there.. I want a little question/answer and exam, NOT NOT NOT a silly pain pill, for Heaven’s sake. I told him this and he acted puzzled and surprised. Do some people go into a clinic and come out satisfied with pain pills???????? There is definitely a place for pain pills I know, but not at this point.

  17. CR
    Reply

    I had been on Nexium about 4 years when I started having IBS. It got so bad that I lost 20 lbs. over 6 months. The bloating caused a loss of appetite. My gastroenterologist ran tests which were inconclusive but never linked the problem to Nexium. When I checked it out on line I found that it will cause intestinal problems. So I quit taking it.
    When they were running tests for this problem they found I had a small aneurysm in my splenic aorta. Although the doctor didn’t mention it, the written report said that it had calcified. At age 70 I questioned what this means, does it mean that my arteries may be calcified, also. Never was I advised to cease taking the calcium supplements. When I questioned my doctor, he said the good the calcium does outweighs the danger to my arteries. I did quit taking it.
    I have been on Zorcor for quite a while. I began noticing that my memory was getting worse. Then I saw where Zorcor will cause a memory loss in some people. I had only been off it a short time when I realized that my memory had improved.

  18. GJD
    Reply

    The credibility of “Big Pharma” is going steadily downhill.
    http://www.economist.com/node/21563689
    I strongly suspect that my GP is liberally funded by the drug companies. I have taken over the responsibility for the research and evaluation anything I am asked to ingest before taking it.

  19. Karen
    Reply

    >”Lack of medication adherence is America’s other drug problem and leads to unnecessary disease progression, disease complications, reduced functional abilities, a lower quality of life, and even death.”
    As if. Sigh. I don’t think the stories presented above are directly relevant to the issue of adherence. IMO, more directly-relevant components of the adherence issue are
    –Habit creating / formation / support (how to take pills reliably)
    –Cost
    –No clear, observable benefit (unfortunately, it’s easy to accommodate to the uncomfortable feelings of high BP and / or blood sugar)
    In addition, the adherence problem is, I would think, highly disease-dependent. How many people fail to adhere to a chemo protocol? Lots of drop-out with HepC and interferon; but I’ll bet it’s WAY higher with Type II diabetes.
    Compare the different adherence rates with Type I and Type II diabetes and you’ll get some actionable information. It’s not the side effects of the drugs there that makes the different. It’s the certainty of death.

  20. BR
    Reply

    Last fall my husband was prescribed a statin. He took it as directed. Pretty soon his hips and legs began to fail – weakness. Finally his new doctor took him off the meds but the weakness remained. It appears he is stuck with that lower body weakness and can barely walk and no strength in his legs. He was a college football player and an active man until the statin evidently crippled him.
    Also I have been prescribed Cipro three times. Each time my reaction was extreme. 1 pill caused a reaction of dizziness, unsettled feelings, panic within 10 minutes. When I complained the doctor became defensive and said I was imagining the symptoms.
    The 2 drugs prescribed for urinary incontinence for me caused me to be dizzy enough to fall twice-I am 78 with bilteral knees and cannot afford to fall.
    I have a paperback PDR now and look at the RX there before it is filled. If I see anything suspicious I do not fill it and add that to my list of Sensitivities.
    After all is said and done this is a business deal between the doctor and the patient. The drug companies should be responsible for their products.

  21. Dwayne S.
    Reply

    I take aldactone, furosimide, lisinopril, hydralazine, carvedilol and terozosin everyday for high blood pressure. I’m 53 yrs old but I feel like 83. I’m achy stiff my legs are super heavy. I recently had a procedure done through simplicity research renal denervation study. They say you can be in the control group or or not had the procedure done. I think I had the procedure done. They kept me overnight. The next day I had little fine bumps on my arms hands and legs and I was itchy. They say it might be from the contrast they used.
    It’s going on a month now my skin has been peeling. Skin is really dry. I go back for a follow up in a couples days. The first couple days my pressure seemed lower now it seems higher then before procedure. I’m tired of doing all this stuff and taking all these medicines and they aren’t even working. I feel old I just want to stop taking these meds. I just have no energy.
    How safe would it be to just stop? If I have to take all these meds that make me feel so bad and even work I’d rather not take them anymore. I don’t know what to do. If you have any advice I’d appreciate it

  22. carla
    Reply

    Thanks so much for your wonderful newsletters, books, and web site. I am a Nurse Practitioner and have learned so much from you. I’ve copied the 10 top screw-up lists from your book and keep it for reference to help me prevent making some of those same mistakes.
    It’s wonderful to be able to suggest more natural benign, often topical remedies for common complaints instead of heavy duty medications with the potential for serious side effects.
    PEOPLE’S PHARMACY RESPONSE:
    Dear Carla,
    It is people like you who make our efforts worthwhile. We cannot tell you how much your thoughtful comments mean to us. We strive to help people make informed choices and we know that as a nurse practitioner your goal is to help people with their diagnosis and treatment.
    We have been disappointed that so few health professionals have even noticed our book, Top Screwups Doctors Make and How to Avoid them, let along commented on it or referred to it as a useful resource. You have just made our day, our week and our month!
    Thank you from the bottom of our hearts.
    Joe & Terry Graedon

  23. jamie
    Reply

    Thank you , thank you, thank you for this article. It took me 5 years to regain normal gut function after being prescribed CIPRO for a simple UTI. Doctors play with these drugs as if they are giving out candy!?!?

  24. M
    Reply

    This is my views: We are in over prescibed medicine world & we feel every problem associated must have answer of pills. NOT TRUE & will reject this notion.
    There are lots of natural prevention & may be treatment but we ignore them due commerical financial incentive of health care co’s. I was associated with several of them.

  25. Mikey
    Reply

    Seven years ago, I was referred to a neurologist following a series of ophthalmic migraines that concerned me. He said I just had to live with them, but prescribed Effexor XR for “anxiety” that I was unaware of. Three days into the Effexor “starter pack” I was so screwed up I sat on the bed for several minutes trying to decide which shoe to put on first. I stopped taking the meds, never returned to that doctor, and am (so far) living happily ever after. The ophthalmic migraines persist, coming in bunches now and then, and I do, in fact, live with them.
    He also prescribed Prednisone for some reason, but the prescription was written so as to be unfillable by the pharmacist. Having lost all trust in this doctor, I never bothered going back to have the Rx corrected.

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