Intended for healthcare professionals

Observations Reality Check

Is your mum on drugs?

BMJ 2011; 343 doi: (Published 24 August 2011) Cite this as: BMJ 2011;343:d5184
  1. Ray Moynihan, author, journalist, and conjoint lecturer, University of Newcastle, Australia
  1. Ray.Moynihan{at}

When “de-prescribing” may be the best medicine

Soon after she went into a small hospital a few years back, Johanna Trimble’s mother in law seemed to enter a rapid physical and cognitive decline.

Fervid Trimble was at the time a woman in her late 80s, living independently in a senior citizens’ home near Seattle in the United States. After a bout of diarrhoea and dizziness she was admitted to the healthcare centre close to the home, but her family was soon shocked by the quick deterioration in her health and the emergence of some strange new symptoms, including delusions. “She wasn’t able to wake up, and we couldn’t wake her,” says Johanna. “It didn’t seem like normal sleep.”

After discussions with the centre’s staff the family discovered that Fervid was taking several new drugs, including a painkiller and an antidepressant. “They said she was depressed,” says Johanna, “but we believed that she was rightly grieving for the loss of her former life, because she was now stuck inside a hospital room. It made sense …

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