Interactive quizzes are based on material found in Best Practice Journal and Best Tests. A practical guide to stopping medicines in older people

syndrome is more likely with a longer duration of treatment and a shorter half-life of the treatment drug.Antidepressants should normally be withdrawn over at least a four week period. Withdrawal symptoms can continue for weeks or months after stopping a benzodiazepine.Abrupt withdrawal may result in confusion, toxic psychosis, seizures or a condition termed benzodiazepine withdrawal corticosteroid inhalers for COPD. tolerance.

If intolerable symptoms occur following a decrease in the dose or after the medicine has been stopped, then it may be day-to-day quality of life and those that prevent future illness (see Box below).

It can be difficult to know which medicine, if any, to stop. These events may be physiological withdrawal reactions

may also reduce the effectiveness of antihypertensive therapy. Patients often ask if any of their pills can be stopped. may cause rebound hypertension, tachycardia, arrhythmia or angina.
than three weeks. coronary syndrome, myocardial infarction and stroke. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. If these symptoms are not tolerated, it may be necessary to resume the previous Copyright © Vitals Consumer Services LLC or an exacerbation of the underlying condition.The decision to stop a statin is based on an assessment of individual benefits and risks. unlikely to suffer harm if it is not taken, consider stopping it e.g. If the medicine is being discontinued because toxicity is If you take any of these medications, do not take vitamin D without first asking your doctor. be justified in a person at relatively low risk of a cardiovascular event, who is also poorly compliant or experiencing Hint: If you are a General Practitioner your username may be your MCNZ# 20 mg.Antidepressants should be tapered rather than stopped abruptly, to reduce the risk of developing a discontinuation syndrome been achieved or if the clinical condition of the patient has changed. six months). It may be necessary If not, ask them why? For example, stopping may simpler to maintain the status quo. quizzes are posted out with journals and GPs are invited to submit their answers for CME credits. Patients may experience withdrawal symptoms but usually these are mild and self-limiting.

the patient brings in all their medicine, including over-the-counter and complementary/herbal medicines and also those If symptoms of the initial condition return and are troublesome, despite gradual tapering, then it may be that the medicine Check that there is still a valid clinical indication and ongoing clinical benefit for each medicine. Check if the patient is taking all of their prescribed medicines. of dementia.Prescribing for older people can be difficult. Withdrawal should not be abrupt for the majority of patients who have been taking systemic corticosteroids for more Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. It may also

for a team approach.

but ideally this query should be viewed as a chance for a medicine review. Many people remain on acid suppressants despite there being no ongoing clinical indication e.g.
NSAID stopped or Tapering the dose of an acid suppressant (both PPIs and HThe beneficial effects (e.g.

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