Are the pills you have taken for years the wrong type? It is quite possible, say experts

Are the pills you have taken for years the wrong type? It is quite possible, say experts

Everyone knows it's important to get the best deal on gas and electricity, credit cards and even travel. If you are loyal to a utility, bank, or airline, you should save money or get better service elsewhere.

So why do not we go about this smart approach to medication?

The short answer is that many who are treated long term may not realize that switching to a new or different drug can bring enormous health benefits to their condition.

Recent NHS figures show that half of Britons currently have a regular prescription and a quarter of us have at least three different types of medications in the long term.

In many cases, they have taken the same pills for years or even decades, often taking side effects or finding that the drugs are not working as they used to.

Recent NHS figures show that half of Britons currently have a regular prescription and a quarter of us have at least three different types of medications (long term).

Recent NHS figures show that half of Britons currently have a regular prescription and a quarter of us have at least three different types of medications (long term).

Recent NHS figures show that half of Britons currently have a regular prescription and a quarter of us have at least three different types of medications (long term).

According to Age UK's Health Advisor Tom Gentry, they may not be the safest, most appropriate or most appropriate drug for their condition. "Some people have drugs that they have been using for years, but things have evolved and alternative options may be available," he explains.

"Doctors should be proactive in prescribing, but there is a tendency to believe the old saying that if it is not broke, do not fix it."

For example, cholesterol-lowering statins taken by six million Britons – one type, atorvastatin, is the best-selling drug in history.

This newer version of the drug was declared a gold standard by the NHS in 2003. However, thousands of patients may still be in older versions that cause more side effects simply because they have not talked to their doctor about switching, experts say.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, says patients should request periodic reviews – and take the opportunity to ask, "Is this the best option or are there alternatives?"

She adds, "To mention side effects, as the dose may need to be adjusted. And what are the risks compared to the benefits: Could you stop taking medication altogether? "

Of course doctors will take the costs into account. "A newer, more expensive drug may not be a tremendous improvement for the patient, so doctors may say a change is unnecessary," says the professor.

With that in mind, we talked to some of the UK's top experts about some of the most commonly used medications and asked if it was time for you to talk to your doctors about whether they should be changed or whether they should be given up altogether.

ARE YOU STILL AT THE SLEEPING TIME YOUR STATIN?

STATINS lower levels of "bad" LDL cholesterol in the blood and more than six million people in the UK regularly take them to fight heart attack and stroke. Common types are atorvastatin (Lipitor), fluvastatin (Lescol) and simvastatin (Zocor).

DO YOU WANT TO SWITCH?

Up to one in ten taking statins develops muscle pain and has been linked to memory disorders and diabetes.

Atorvastatin, a newer statin type, is one of the best means of lowering cholesterol. However, there are patients who are still taking older Statin versions that are less tolerated and less effective.

Professor Kausik Ray, honorary cardiologist at St. George's Hospital in London, says: "Older statins have a short duration and become less effective within a few hours.

"Since cholesterol production in the body reaches a peak during sleep during sleep, we recommend that patients take the statin at bedtime.

"Recent statins such as atorvastatin and rosuvastatin are effective for much longer and can be taken at any time."

Under development are newer drugs that act similar to statins and can be used alongside them. Currently, however, they are not available to most NHS patients. These include lipoprotein lipase inhibitors, which act by lowering the levels of fat in the blood and another class of medicines called PCSK9 antibodies.

Peter Sever, Professor of Clinical Pharmacology at Imperial College, London, says, "These are already available to patients who have high cholesterol, as well as to those who have already had a few heart attacks."

… OR DITCH?

Most patients who are prescribed statins need to continue taking them, says dr. Laura Corr, cardiologist at Guy's and the St. Thomas Foundation Foundation. Doctors consider the risk of heart attack before they offer statins. Cholesterol is a factor but age, weight, smoking and family history are different.

With a healthy Mediterranean diet, you can lower cholesterol by up to 20 percent. However, Dr. Corr: "The likelihood of having a heart attack increases with age and medications are still the best way to keep the risk low with age."

THREE NEW MEDICINES FOR TYPE 2 DIAGBET

Metaformin is almost 100 years old, but remains the most common drug given to patients with type 2 diabetes, which affects three million Britons. Also known as Glucophage, it reduces the amount of sugar that the liver gives into the blood.

DO YOU WANT TO SWITCH?

Common side effects of taking Metformin are nausea and diarrhea, but this is dose-related, says Philip Newland-Jones, a pharmacist at University Hospitals Southampton.

"This affects about 15 percent of patients, but there is no reason to stop – a slight dose reduction helps," he says.

Very rarely, metformin can alter your taste or cause liver problems.

Newer medications that increase natural insulin levels can be prescribed if metformin does not properly control or tolerate blood glucose. These include popular gliflozines (also known as SGLT-2 inhibitors), incretin mimetics (or GLP-1 agonists) and gliptins, also known as DPP-4 inhibitors.

… OR DITCH?

Weight loss alone can slow the progression of type 2 diabetes and even cause remission, so that metformin is no longer needed. In long-term illnesses, however, a diet is less effective.

Mr. Newland Jones says, "Many people have had the disease for a long time when they were diagnosed. It is important not to ignore the symptoms and take advantage of free check-ups in pharmacies and surgical procedures. "For more information, visit diabetes.org.uk.

ARE YOU SURE THAT THE WAR IS GOING?

Not so long ago, anyone who needed a blood thinner to prevent a stroke, heart attack, or deep vein thrombosis was prescribed warfarin. Many of the estimated 1.4 million Britons with atrial fibrillation or other cardiac arrhythmias use the drug daily to prevent blood clots. It reduces the ability of the liver to produce blood clotting proteins.

DO YOU WANT TO SWITCH?

While warfarin is effective, it is not easy to take. Matt Fay, a Bradford-based general practitioner specializing in heart health.

"What you eat and what other medications affect the absorption of the drug, warfarin levels in the blood can vary. Too much can lead to serious complications, including bruising and bleeding. Patients need monthly blood tests to check that their drug levels are stable.

"Newer anticoagulants [drugs that stop blood clots] have been recently developed, which are more stable, so no blood tests are needed. "

These newer types of anticoagulants, collectively referred to as NOACs, may be safer and more effective than warfarin.

Aspirin is also a blood thinner that stops the accumulation of platelets to form blood clots. According to Dr. Fay, however, this is an ineffective treatment for patients with atrial fibrillation. Any patient receiving aspirin for this condition should switch to warfarin or a NOAC.

… OR DITCH?

For most people who have prescribed anticoagulants, the benefits outweigh the risks. These include heavy bruising, prolonged nosebleeds and blood in the urine or bowel movements. People should not stop taking anticoagulants before they see their doctor. Fay. Thanks to a recent ruling, patients with atrial fibrillation can be taken medication if the risk of stroke is considered low.

Do not let the powerful PAIN PILLS hook you

Last year, 23.8 million prescriptions for analgesics based on opioids such as codeine, oxycontin and tramadol were issued by family physicians in England – an increase of ten million in a decade. It is believed that an aging population and a greater demand for greater pain relief are to blame.

DO YOU WANT TO SWITCH?

OPIOIDS trigger the production of dopamine, which is responsible for feeling in the brain, says Roger Knaggs, spokesman for Nottingham University, spokesman for the British Pain Society. However, they can be addictive depending on the dose and duration of use.

"Opioids are best for people who have serious injuries or illnesses like cancer. But it should only be a short-term solution, "he says.

Itchy skin, nausea, confusion, libido loss and mood swings are side effects.

Buprenorphine is a novel opioid drug that is administered via an adhesive skin patch and has fewer side effects and is less addictive.

"Another option is gabapentin, a drug without morphine that has been developed to treat seizures and can also be used to treat nerve pain," says Prof. Knaggs. "But it can cause drowsiness."

Antidepressants, including amitriptyline, are used to treat pain caused by nerve damage, but can only be effective for a few patients.

… OR DITCH?

Dr. Anthony Ordman, Consultant Pain Medicine and President of Pain Medicine, Royal Society of Medicine, says patients should be referred to specialized pain clinics if the family doctor has no options. "We use the skills of doctors, nurses, physiotherapists and psychologists to reduce the symptoms of chronic pain," he adds. Non-drug therapies such as psychotherapy or non-invasive transcutaneous electrical nerve stimulation devices can be used to reduce medication.

One in six adults in the UK take antidepressants to treat depression, anxiety and other mental disorders (image)

One in six adults in the UK take antidepressants to treat depression, anxiety and other mental disorders (image)

One in six adults in the UK take antidepressants to treat depression, anxiety and other mental disorders (image)

against press

One in every six British adults takes antidepressants for the treatment of depression, anxiety and other mental disorders. According to the NHS guidelines, treatment should take at least six months, but some patients are reported to be indefinitely recommended. Most commonly prescribed are selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, sertraline, and citalopram, which increase mood-associated neurotransmitters, including serotonin. Tricylic antidepressants, including amitriptyline, are commonly prescribed if other antidepressants are not effective.

DO YOU WANT TO SWITCH?

Long-term use of antidepressants can lead to lower libido and trigger anxiety, insomnia and headaches. Tricyclics can cause constipation, dry mouth and tiredness, low blood pressure and irregular heart rate.

If you have side effects, mirtazapine (Zispin) causes less sexual problems and sleep disturbances.

One of the newest drugs available is Vortioxetine (Brintellix), an SSRI that also appears to improve memory and perception. However, it is currently only recommended by NICE as a third-line treatment if other treatments do not work because they are patented and expensive. Another drug, agomelatine, has had good results and seems to cause few side effects.

… OR DITCH?

"If you take antidepressants for more than a year, you can probably replace them," says Professor David Taylor, spokesman for the Royal Pharmaceutical Society. "Your family doctor can give recommendations for gradual dose reduction."

The waiting times for psychotherapy can be six months or longer, but it is worthwhile to get a hint as soon as possible.

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