Geriatric Psychiatrist Offers Tips for Older Adults to Avoid the Dangers of Mixing Medications

woman sorting medication pills

In my role as a geriatric psychiatrist, I recently saw a woman in her 60s who had been diagnosed two years earlier with bipolar 1 disorder after she started experiencing memory changes, impulsive behavior and extreme mood swings. The woman, who I’ll call Jane, was placed on several medications that included mood stabilizers, sedative-hypnotics, antipsychotics and anti-anxiety drugs.

Unfortunately, this mix of prescription medication made her very drowsy. One night at home, she fell and broke her hip.

Ashish Sarangi, MD
Ashish Sarangi, MD

Jane’s experience is an example of the dangers of polypharmacy — the use of multiple medications at the same time. According to one study, 40-60% of older adults take more than one prescription drug.

The dangers of mixing multiple medications include falls, confusion and increased side effects. This is especially concerning for older adults. As our bodies age, the organs responsible for breaking down and flushing out medications — the liver and the kidneys — do not function as well as they did when we were younger. This allows a toxic buildup of the broken-down drugs to linger in your body and cause problems. Also, many medications interact with each other, and their levels can be influenced by the foods we eat.

The World Health Organization estimates that by 2050, 22% of the population will be 60 or older, compared to 12% in 2015. That’s why some public health experts worry that polypharmacy will be the next global epidemic.

What can you do protect yourself? Here are some tips.

  • Make lists of your medications. Write down every medication you take, how often you take it and why you take it. Keep one list with your medical records at home, put another in your wallet or purse and give a third to a friend or loved one. You will have it handy to show your doctor or pharmacist, and it will easily be found in case of emergency.
  • Keep an open line of communication with your physician. Ask your doctor at each visit the reason why you take a particular medicine and if the dose and the reason you’re taking it is still appropriate.
  • Manage medications in a pillbox. Keeping medications organized in a pillbox can prevent taking multiple doses of the same medication
  • Dispose of expired medications. Getting rid of old medications by returning them to a pharmacy can help you avoid accidentally taking expired drugs.
  • Seek assistance. Often, it may be necessary to call on a trusted family member or friend to help you take medications safely, especially if you have memory issues.

As for Jane, she is on the mend from her hip injury. When we evaluated her, we found she originally had been misdiagnosed, and we’ve adjusted her medications to keep her safe. She is more alert during the days and able to interact with her family and enjoy time with her grandchildren. You don’t want to go through what Jane did to learn about the dangers of mixing medications, so please, make sure your doctor and pharmacist know about all the medications you’re taking.

Ashish Sarangi, MD, is a psychiatrist at MU Health Care with special fellowship training in geriatric psychiatry.

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