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When a medical misadventure or new symptoms develop, physicians will often consider if the event is a side effect of a medication. This can be very difficult to establish. For example, if a patient is given medication to treat colitis and the diarrhea worsens, is this a side effect of the medicine or a worsening of the colitis?
Physicians face these dilemmas all the time. If a patient develops a symptom, and a
side effect is being considered as an explanation, the doctor either knows or
researches if there is medical evidence supporting a side effect event in this specific
circumstance. If a patient develops
headaches after a new medicine is prescribed, and this symptom has never been
reported as a side effect of the medicine, then the drug is likely not the
cause. Of course, just because a
side effect has not been reported, does not guarantee that one has not occurred. As
every doctor knows, patients often look up the side effect profiles of their
drugs and decide that their nausea, fatigue, and GI symptoms must be drug-related since these symptoms are on the drug’s side effect list. Good luck finding a drug that doesn’t include
nausea as a potential side effect! It’s
a wonder that patients who review the extremely long list of side effects of
proposed drugs actually take them! We’ve
all heard the ubiquitous TV drug ads which conclude with rapid-fire recitations
of horrendous possible side effects, which often include fatalities. I’m a doctor, and I get spooked listening to these
lists!
Thankfully, most medicines cause either no side effects or only
mild ones. Deciding if a side effect is
even present can be challenging.
Physicians may opt to discontinue a drug, not knowing for certain if the medicine
is the culprit. This is not always a
clean exercise, as some side effects can linger on for weeks or longer.
Here’s an effective strategy to minimize your risk of
developing drug side effects. Advocate
for yourself. Is the proposed medicine
absolutely necessary? Is there a safer
drug available? Are you prescribed the
lowest dose necessary? The rocket fuel
for medication side effects is the disease of polypharmacy, which is raging out
of control. How long is your medication
list? Are several different physicians and medical
professionals prescribing your drugs? Are all of them truly necessary? Is there a primary care physician in charge to whom the consultants are accountable? Is there a medical professional assessing with some regularity the continued need for
all of your medicinal potions?

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