Too Many Pills? Why ‘Less Is Often More’ for Older Adults
- Bilal Mannan, MD
- 5 days ago
- 2 min read
The case for deprescribing, and why it could be one of the best things we do in senior care.
We don’t talk enough about stopping medications.
In the world of modern medicine, it's easy to keep adding—one prescription after another, often by different doctors, over many years. But as we age, the balance between benefit and harm changes. What once helped might now hurt. What once made sense may no longer be necessary.
That’s where deprescribing comes in.
What is deprescribing?
Deprescribing is the thoughtful process of reducing or stopping medications that may no longer be helpful—or may actually be causing harm.
It’s not about “giving up” or denying care. It’s about refining and simplifying—so medications work for someone, not against them.
Why is this especially important for older adults?
As we age:
Our metabolism slows down—medications stay in the system longer
Our kidneys and liver process drugs differently
We become more sensitive to side effects like confusion, dizziness, or low blood pressure
The risk of drug interactions skyrockets—especially with 5+ medications on board
Many seniors are on 7, 10, even 15 prescriptions. It's called polypharmacy, and it’s linked to:
Falls
Memory problems
Hospitalizations
Poorer quality of life
Some of these medications were once appropriate. But bodies change. Goals change. And so should the medication list.
Common meds that often deserve a second look:
Sedatives (like benzodiazepines) — Risk of falls, confusion, dependence
Proton pump inhibitors (like omeprazole) — May increase risk of fractures and nutrient deficiencies if used long-term without clear reason
Blood pressure meds — May need to be lowered or stopped in frail patients prone to dizziness or falls
Antihistamines like diphenhydramine (Benadryl) — Often too sedating and impair cognition
Statins — May no longer offer meaningful benefit for those with limited life expectancy or high pill burden
This doesn’t mean these drugs are “bad”—it means the context matters.
How do we deprescribe safely?
At Sina Health, we approach deprescribing as a collaborative process. It’s not about ripping away meds. It’s about careful review, honest conversations, and slow, supported changes.
We ask:
What’s this medication doing for you now?
Are you having any side effects?
Are there safer alternatives?
Are your life goals and care goals still aligned with this treatment?
Sometimes we reduce the dose. Sometimes we replace a medication. Sometimes we just watch and wait.
It’s deliberate. And it can be life-changing.
What’s the goal?
Not “zero pills.”
The goal is:
Fewer side effects
Improved energy, cognition, balance
Less burden—financially, mentally, and physically
A medication list that actually reflects your values and needs
In many cases, deprescribing improves health more than adding something new.
Worried your med list is too long—or too risky?
We’re here to help you sort through it. Thoughtfully, safely, and with your best interests first.
Good doctors prescribe medications. Great doctors know when to stop them.
