{"id":154717,"date":"2025-06-03T11:55:11","date_gmt":"2025-06-03T11:55:11","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/154717\/"},"modified":"2025-06-03T11:55:11","modified_gmt":"2025-06-03T11:55:11","slug":"millions-take-more-than-10-pills-a-day-now-doctors-warn-results-can-be-catastrophic-patients-arent-being-told-and-the-drug-cocktails-you-must-avoid","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/154717\/","title":{"rendered":"Millions take more than 10 pills a day. Now doctors warn results can be catastrophic, patients aren’t being told – and the drug cocktails you must avoid"},"content":{"rendered":"

Tony Courtney Brown was a far-from-well man when he was taking 24 tablets a day for half a dozen complaints.<\/p>\n

Then in his early 60s, he was being treated for depression<\/a> with three antidepressants, and was given higher and higher doses of the opioid painkiller tramadol, along with gabapentin, both for back pain.<\/p>\n

\u2018I was also taking medication for an enlarged prostate, for constipation [caused by the tramadol], omeprazole [for acid reflux caused by the antidepressants] and Cialis for libido problems [also caused by the antidepressants],\u2019 recalls<\/a> Tony, now 67, a former local authority housing director who lives in Wimbledon<\/a>, south-west London<\/a>, with his wife Anoma, 66.<\/p>\n

\u2018These made me gain more than two stone, I was in constant discomfort and I felt like a zombie. But every year my doctors just gave me more drugs.\u2019<\/p>\n

More than a million people in England are being prescribed ten or more medications a day, according to a new report by the NHS<\/a> Health Innovation Network. They are three times more likely to suffer harm as a result, as taking large numbers of pills greatly increases the chance of having a drug interaction, or of experiencing side-effects including confusion, dizziness or gastric problems.<\/p>\n

This is because, while medications are generally prescribed for good reason to treat different ailments, in combination they can interact and cause side-effects, leading to a cascade of prescriptions to treat those side-effects.<\/p>\n

Problematic polypharmacy \u2013 the combined adverse effects of multiple medications, usually defined as more than five a day \u2013 is a growing problem, the new report says. It can have serious consequences, leading to falls, emergency hospital admissions and death. Older people are at particular risk.<\/p>\n

Under the General Medical Services contract, GPs are advised to do a medication review every 15 months for patients on repeat prescriptions.<\/p>\n

\"Tony <\/p>\n

Tony Courtney Brown was taking 24 pills a day to deal with half a dozen complaints in his 60s<\/p>\n

\"While <\/p>\n

While medications are generally prescribed for good reason to treat different ailments, in combination they can interact and cause side-effects<\/p>\n

More in-depth medication reviews are available for people taking five or more daily medications from GPs, practice-based pharmacists and advanced nurse practitioners. These are for people deemed to be most at risk from polypharmacy, such as older frail people.<\/p>\n

Community pharmacists also conduct medication reviews via the New Medicine Service to explain how medicine should be taken and any side-effects. These are available on request from pharmacists and consist of three appointments over several weeks, in person or over the phone.<\/p>\n

But many patients may be missing out on formal reviews. NHS England data shows that medication reviews make up less than 1 per cent of all GP appointments.<\/p>\n

Patients need regular medication reviews \u2018just like a car needs an MOT to keep it on the road\u2019, Steve Williams, lead clinical pharmacist at the Westbourne Medical Centre in Bournemouth, and one of the authors of the Health Innovation Network report, told Good Health.<\/p>\n

\"Steve <\/p>\n

Steve Williams, lead clinical pharmacist at the Westbourne Medical Centre in Bournemouth<\/p>\n

These should be made available to those who are most at risk, including the frail, over-85s, people in care homes, and those who take ten or more medications a day, he says.<\/p>\n

\u2018These people in particular need at least an annual review because something that was started in good faith five years ago may no longer be appropriate,\u2019 he says.<\/p>\n

\u2018If we keep adding in medicines and not subtracting you can just multiply the problems.\u2019<\/p>\n

Sultan Dajani, a pharmacist in Hampshire, says anecdotally he hears that GP practices are often too stretched to do regular medication reviews.<\/p>\n

The service that alerts GPs and pharmacies to patients\u2019 medication changes is also inconsistent, he says. \u2018We have a national Discharge Medicines Service across hospitals which sends notes to GP surgeries and pharmacies \u2013 but we don\u2019t always get those.<\/p>\n

\u2018This means a GP or pharmacist might be unaware a patient\u2019s medication has been changed in hospital, so they are put back on the drugs that have been stopped,\u2019 he explains.<\/p>\n

\u2018I had a patient recently who was admitted to hospital and given an anti-stroke drug, but he had been on aspirin. If he\u2019d taken both, it would have thinned his blood too much and he could have bled to death.\u2019<\/p>\n

Common combinations that can be problematic include diabetes medications called SGLT-2 inhibitors (e.g. dapagliflozin) with diuretics (such as furosemide) for high blood pressure, says Sultan Dajani. This mix can increase the risk of dehydration and cut blood pressure too much.<\/p>\n

Another is naproxen (a painkiller) and warfarin (a blood thinner). \u2018Naproxen stops warfarin working \u2013 this might result in patients having a bleed,\u2019 he says.<\/p>\n

He often sees elderly patients with dizziness and confusion because of the combined effects of being on multiple blood pressure-lowering drugs, which can lead to falls and hip fractures.<\/p>\n

Some drug combinations could even lead to a misdiagnosis, says Chris Fox, an old-age psychiatrist and professor of clinical psychiatry at the University of Exeter.<\/p>\n

As he explains, many commonly prescribed drugs have an anticholinergic effect \u2013 i.e. they block acetylcholine, a chemical messenger in the brain.<\/p>\n

These drugs include some antidepressants, antihistamines, bronchodilators for asthma, anti-tremor medication for Parkinson\u2019s and overactive bladder pills.<\/p>\n

The combined effect of being on more than one of these can lead to confusion and memory loss, which is then mistaken for dementia, says Professor Fox.<\/p>\n

\u2018I\u2019ve seen patients admitted to hospital who appear very confused, even with delirium [where they are hallucinating] and dementia is suspected. Yet when they\u2019re taken off the drugs they are completely normal. The effects can be quite dramatic.\u2019<\/p>\n

Treatment with multiple blood pressure drugs \u2013 common in older people \u2013 can lower blood pressure too much. This can make patients feel fatigued and lead to a misdiagnosis of depression.<\/p>\n

\u2018Yet instead of a doctor realising it\u2019s a side-effect of multiple drugs, the patient gets prescribed antidepressants which can cause even more side-effects,\u2019 says Professor Fox.<\/p>\n

For each additional prescribed medication older patients took, there was a 3 per cent increased risk of dying, according to a 2022 study of 85-year-olds by Newcastle University.<\/p>\n

Problematic polypharmacy affects younger people, too. A 2019 study in the journal PLoS Medicine identified the problem in people of all ages with respiratory issues, mental illness, metabolic syndrome, pain and hormone conditions.<\/p>\n

Almost a fifth of unplanned hospital admissions were due to adverse drug events, reported the BMJ in 2022 \u2013 and many of these patients were on multiple medications (on average ten a day).<\/p>\n

The medicines most implicated were diuretics, steroid inhalers, proton pump inhibitors (e.g. omeprazole) for acid reflux, anti-clotting drugs and blood pressure pills \u2013 many commonly prescribed drugs. The researchers from Liverpool University calculated that 40 per cent of these admissions were preventable.<\/p>\n

As many as 10 per cent of items prescribed in primary care need not have been issued, according to the 2021 National Overprescribing Review led by Dr Keith Ridge, then the Chief Pharmaceutical Officer for England<\/a>. The causes included single-condition guidelines (i.e. not joining the dots for people with multiple illnesses), an inability to access full patient records and a lack of alternatives to prescribing medication.<\/p>\n

Professor Sam Everington, a GP in east London, has long championed \u2018social prescribing\u2019 \u2013 non-drug treatments such as lifestyle changes \u2013 and argues that alternatives to medications should be considered in more cases.<\/p>\n

\u2018Doctors\u2019 training puts disproportionate emphasis on drugs, and NICE clinical guidelines further drive this medicalisation,\u2019 he says.<\/p>\n

Clare Howard, deputy chief pharmaceutical officer for NHS England and the Royal Pharmaceutical Society spokesman on polypharmacy, says it\u2019s not the fault of a particular profession, it\u2019s more a system issue.<\/p>\n

\u2018As many of us are living longer with multiple, long-term conditions, medicines get added and we don\u2019t have enough processes in place to allow us to review a patient regularly and take some of these drugs out.\u2019<\/p>\n

In 2019 Tony, feeling that the drugs lay at the root of his problems, asked a GP for support to reduce his antidepressants.<\/p>\n

Later, he decided to come off all his medications and turned to complementary therapists.<\/p>\n

\u2018I\u2019ve changed my diet and lifestyle and learnt how to manage stress. I\u2019m probably healthier now than at any time in my life,\u2019 says Tony, who has since retrained as a holistic therapist.<\/p>\n

\u2018Looking back, I\u2019m angry that my medication wasn\u2019t regularly reviewed. The drugs ended up doing me more harm than good.\u2019<\/p>\n","protected":false},"excerpt":{"rendered":"Tony Courtney Brown was a far-from-well man when he was taking 24 tablets a day for half a…\n","protected":false},"author":2,"featured_media":154718,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4315],"tags":[92,105,257,4326,16,15,5068],"class_list":{"0":"post-154717","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-dailymail","9":"tag-health","10":"tag-london","11":"tag-medication","12":"tag-uk","13":"tag-united-kingdom","14":"tag-wimbledon"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114619306747292030","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/154717","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=154717"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/154717\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/154718"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=154717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=154717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=154717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}