The purpose of prescription drugs is to heal, but for older people, they can quietly become the source of serious harm. Older people have more prescription medications than any other age group, and these prescriptions usually include medications known to be at risk or even dangerous to aging.
Why does this happen? Often, this is an outdated approach, a lack of communication between experts and an underestimation of how the aging process changes the body’s handling of drugs. As you age, your kidney and liver function decline, your body fat increases, and your brain chemistry transfers, all of which affect how the drug works. Once a safe, effective treatment could turn into a high-risk cocktail.
Here are six medicines that are usually prescribed to older people, which may do more harm than good, and why every elderly person (and their caregivers) should think twice before taking them.
Still prescribed dangerous drugs
1. Benzodiazepines (e.g., Valium, Xanax, ativan)
These drugs are often used to treat anxiety, insomnia and panic attacks, but they pose serious risks to older people. Benzodiazepines work through a calm central nervous system, which may temporarily relieve but can also cause extreme drowsiness, confusion, memory problems and falls.
For older adults, even small doses can impair balance and coordination, increasing the risk of fractures and hospitalization. Long-term use is even more concerning, and studies link benzodiazepines to decreased cognitive ability and higher risk of dementia.
Despite these dangers, many doctors are still prescribing, often for quick resolution of sleep problems or anxiety without adequately weighing the risks. Safer alternatives, such as treatments, sleep hygiene habits, or certain antidepressants, are often overlooked.
2. Anticholinergic drugs (e.g. Benadryl, Elavil, detrol)
Anticholinergics are a wide range of medications used to treat everything from allergic and hyperactive bladder to depression and illness. But they also block neurotransmitters called acetylcholine, which play a key role in memory and learning.
In older adults, this can lead to confusion, blurred vision, dry mouth, constipation and, most shockingly, an increased risk of dementia. In fact, long-term use of anticholinergic drugs is directly related to cognitive decline in older adults, but these drugs are still usually prescribed or purchased over the counter.
Playing football? Many older people take more than one anticholinergic without realizing it, complicating the risks. Regular drug reviews are crucial to capturing these hidden threats.
3. NSAIDS (e.g., ibuprofen, naproxen)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to manage pain, arthritis and inflammation. But for the elderly, the risks are usually greater than the benefits. Long-term use of NSAID can cause gastric blood, ulcers, kidney damage and even heart problems.
Older people are particularly vulnerable because their renal function has decreased with age. The risk increases when NSAID is used in combination with other drugs (such as diuretics or blood pressure drugs) such as those that are common in older patients.
If not supervised, even occasional use can be risky. Alternatives such as acetaminophen, physical therapy or local pain relief are generally safer and are equally effective for many older people.
4. Sleep AIDS and “Z-drugs” (e.g., Ambien, Lunesta, Sonata)
Sleep problems are common among older people, and doctors often prescribe “Z-Crugs” to help. These drugs are sold as safer alternatives to benzodiazepines, but they carry many of the same risks – including daytime sleepiness, dizziness, falls and memory errors.
Some older people have reported falling asleep while sleeping under the influence of these drugs, eating at night, and even driving. Worse, they usually stop working over time, increasing dose and dependency.
Instead of addressing the root causes of insomnia such as depression, chronic pain or sleeping habits, these drugs can provide a quick repair of long-term consequences.
5. Antipsychotic drugs (e.g., Seroquel, Risperdal, Haldol)
These powerful drugs are sometimes inappropriately used to control the behavior of older people with dementia, especially in nursing homes or assisted living facilities. While they may calm down or aggress, they incite or aggression at a high cost.
Antipsychotics can cause sedation, tremors, weight gain, and even increase the risk of stroke and sudden death in Alzheimer’s patients. In fact, the FDA has issued a black box warning to warn them of their use in that population, but they still often prescribe “behavioral management” outside the label.
There are non-pharmacological approaches, such as music therapy, routine changes or environmental modifications, which are safer and often more effective. Unfortunately, these require time and training, which is lacking in many caregivers and facilities.
6. Digoxin (brand name: Lanoxin)
Digoxin is an older drug used to treat heart failure and irregular hearts such as atrial fibrillation. Although it can save lives under appropriate circumstances, it has a very narrow therapeutic window, which means the difference between useful and toxic doses is thin.
Due to age-related changes in renal function, older people are more sensitive to digoxin, which affects how the drug is removed from the body. Digoxin toxicity can cause nausea, vision changes, confusing and even fatal heart rhythms.
Despite safer and more modern alternatives, polyoxygenin is still in use, especially in patients who have been in it without a comprehensive drug review.
It’s time to rethink the “routine” prescription
Just because the drug has been around for decades or has been prescribed by a trusted doctor does not mean it is safe, especially for older people. The aging body metabolizes drugs differently, and it is dangerous for someone in the 40s or 80s.
If you are a senior or caregiver, one of the most important things you can do is to check all your medications regularly with a healthcare provider (ideally a pharmacist or geriatric doctor specialist). Ask difficult questions. Request a safer alternative. Promote non-drug solutions when appropriate.
Because in the end, the goal is not only to treat symptoms. It is to preserve quality of life, independence and clarity as long as possible.
Will you or someone you like experience unexpected side effects from your prescription?
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