Medication Reviews: When Seniors Should Stop or Deprescribe Medicines

More than half of adults over 65 take five or more prescription drugs every day. Some of those pills may no longer be helping them - and could even be hurting them. It’s not about cutting corners. It’s about deprescribing: the careful, intentional process of stopping medicines that don’t belong anymore.

Why Stopping Medicines Can Be Healthier Than Keeping Them

It’s easy to assume that more meds mean better care. But for older adults, that’s often not true. Taking too many drugs - called polypharmacy - raises the risk of falls, confusion, kidney damage, and hospital visits. In the U.S., over $30 billion is spent each year treating side effects from medications that older people shouldn’t be taking. Many of those reactions are preventable.

Deprescribing isn’t about quitting meds cold turkey. It’s about asking: Is this still doing more good than harm? For someone with advanced dementia, a statin to lower cholesterol might not matter if they’re not living long enough to benefit from it. For someone with frailty and no heart disease, a blood thinner might increase their risk of a dangerous bleed more than it prevents a stroke.

The idea isn’t new. It was first formally proposed in 2003 by an Australian doctor. Since then, research has shown that when done right, stopping unnecessary drugs reduces hospital readmissions by up to 25% and cuts adverse drug events by 17-30%. Quality of life improves - people feel clearer-headed, less dizzy, and more in control.

When It’s Time to Talk About Stopping

You don’t need to wait for a crisis to start this conversation. Here are clear signs it’s time to review your meds:

• You’ve started noticing new symptoms - dizziness, confusion, fatigue, stomach upset - after adding a new drug. These aren’t just "getting older." They could be side effects.
• You’ve been diagnosed with a serious condition like advanced dementia, end-stage heart failure, or cancer with limited life expectancy. Preventive drugs (like those for high cholesterol or osteoporosis) may no longer make sense.
• You’re on high-risk drugs: benzodiazepines for sleep, antipsychotics for agitation, long-term proton pump inhibitors (PPIs) for heartburn, or multiple blood thinners together.
• You’re taking drugs meant to prevent future problems - like a daily aspirin or a bone drug - but you’re not living long enough to see the benefit.

The American Geriatrics Society and the American Academy of Family Physicians both agree: if a drug doesn’t match your current health goals, it’s time to reconsider. That means asking your doctor: What was this for? Is it still helping? What happens if we stop it?

How Deprescribing Actually Works

This isn’t a one-time decision. It’s a process.

First, your doctor or pharmacist looks at your full list - all prescriptions, over-the-counter pills, vitamins, and supplements. They use tools like the Beers Criteria or STOPP guidelines, which list drugs that are risky for older adults. But the real work happens when they ask: What matters to you?

If you want to stay independent at home, a medication causing dizziness needs to go. If you’re tired of swallowing 12 pills a day and just want to feel more like yourself, some drugs can be dropped.

Then, they pick one drug to try stopping. Not all at once. Stopping one at a time lets you see what changes. Did your sleep improve? Did your nausea go away? Did your balance get better? That’s the feedback loop that guides the next step.

Some drugs need to be tapered slowly - like antidepressants or steroids. Others can be stopped quickly - like a daily antacid you’ve been taking for years without a diagnosis. Your pharmacist can help you figure out which.

Who Should Be Involved

This isn’t just your doctor’s job. It’s a team effort.

Clinical pharmacists are often the best people to lead medication reviews. They’re trained to spot interactions and unnecessary drugs. Many hospitals and community pharmacies now offer free medication reviews for seniors. Ask your pharmacy if they do it.

Family members and caregivers play a big role too. They notice changes in mood, energy, or memory that the patient might not mention. They can help track symptoms after a drug is stopped.

And you - the patient - are the most important voice. If you feel worse on a drug, say so. If you’re taking something because "the doctor said so," but you don’t remember why, speak up. Your preferences matter. Your goals matter. Your quality of life matters.

What Happens When You Stop

Some people worry that stopping a drug will make their condition worse. That’s a real concern - but only if done without care.

For example, stopping a PPI (a heartburn pill) might cause temporary rebound acid, but that usually fades in days. Stopping a sleep aid might lead to short-term insomnia, but many older adults find they sleep better naturally after a few weeks.

The key is monitoring. Your doctor should schedule a follow-up - even just a quick call - within two weeks. Ask: Did anything change? Any new symptoms? If something bad happens, you can restart. But if you feel better? That’s the win.

Studies show that when deprescribing is done carefully, disease outcomes don’t get worse. Blood pressure stays controlled. Diabetes stays managed. The only thing that changes is fewer side effects and more freedom.

Barriers and Myths

Why isn’t this done more often?

One big reason: doctors aren’t trained to stop things. Medical education focuses on starting treatments, not stopping them. Many prescriptions get renewed automatically - year after year - without review.

Another myth: "If it’s not broken, don’t fix it." But if a pill is causing you to stumble, or making you foggy-headed, it’s broken. You don’t need to suffer just because a drug was prescribed years ago.

Also, patients often feel guilty about questioning their doctor. But asking, "Should I still be taking this?" is smart. It’s part of being an active partner in your care.

What You Can Do Right Now

You don’t need to wait for an annual checkup. Here’s what to do today:

1. Write down every medication you take - including vitamins, herbal supplements, and over-the-counter pills.
2. Ask your pharmacist to review them. Many offer free medication reviews.
3. Make a list of your health goals: "I want to walk without falling," "I want to stop feeling tired all day," "I want to take fewer pills."
4. Bring that list to your next doctor visit and say: "I’d like to talk about which of these I still need."
5. Ask: "If we stopped this, what would we watch for? What would happen if it didn’t work?"

There’s no rule that says you have to take every pill you’ve ever been given. Medications are tools - not permanent fixtures.

The Bigger Picture

This isn’t just about one person’s pill bottle. It’s about a broken system. In Scotland, the number of older adults on five or more drugs doubled in 15 years. In the U.S., it tripled. That’s not progress. That’s a public health risk.

Organizations like the World Health Organization and the U.S. Agency for Healthcare Research and Quality now call deprescribing a key patient safety strategy. Electronic health records are starting to flag high-risk meds. Apps like Deprescribing.org offer free guides for common drugs - from sleeping pills to acid reducers - with step-by-step plans for stopping safely.

The future is personalized. AI tools are being tested to predict which seniors are most at risk from polypharmacy. But right now, the most powerful tool is simple: asking the right questions.

Frequently Asked Questions

Next Steps

If you’re helping a senior loved one: sit down with them. Get the full list of meds. Call their pharmacy. Ask if they offer a free review. Go to Deprescribing.org - it’s free, reliable, and has easy-to-read guides for common drugs.

If you’re a senior yourself: write down your top health goals. Write down every pill you take. Then ask your doctor: "Which of these are still helping me?" That simple question can change your life.