We're Overmedicating the Elderly
Interview with Dr. Gary Kohls
Interviewed by Raena Morgan
October 13, 2008
Raena Morgan: Dr. Kohls, you’ve indicated that the elderly are easy targets for over-medication. Could you explain that, please?
Dr. Gary Kohls: Yeah. You know, I think the average Medicare-age patient, I’ve read somewhere, takes six different drugs or something like that. And it’s some of the—most drugs affect the brain, you know.
RM: Okay.
GK: But they’re taking stuff—Lipitor, their coumadin, and they’re taking antidepressants and they’re taking something for their bowels and—
RM: Why are they taking antidepressants? Is aging depressing?
GK: Well, it can be. So many of your friends are dying and there’s lots of losses and your connection with your kids and grandkids—
RM: Okay, so there are some depressing.
GK: So, our culture is separating families and that’s kind of sad for a lot of people. And sometimes if, you know, common sequences, you know, go to your doctor for your exam and you might be nervous, blood pressure’s up. Now elevated blood pressure and now you have a label of hypertension. Whereas what you should do is say, “well, let’s check about 20 different blood pressures at different times of the day and at home and etcetera before we make a decision.” But it’s easy just with one elevated reading, it might be just a temporary thing because you’re nervous in the doctor’s office and now you’re on a drug. And if you get a drug like a beta blocker, that can cause depression, you know. Inderal and Toprol cause depression. It’s a blocker of dopamine and neuroepinephrine. Dopamine and neuroepinephrine are natural antidepressants and now you’re on a drug that lowers it because it’s counteracting epinephrine—it blocks epinephrine, and epinephrine raises pulse and blood pressure, so this is a drug that will lower that and it does lower your blood pressure. But because dopamine and neuroepinephrine are antidepressants, now you’re blocking that. And so, depression is a very common side effect of a drug for blood pressure. Well, so now the person goes in, blood pressure’s fine, but now he’s complaining of depression. Well, two minutes, here’s a prescription for Prozac. And so, they take the Prozac and maybe that helps a little bit for awhile, but it probably poops out. But it can cause mania or insomnia. Then, they go back and say, “I’m not sleeping very well.” Well, here’s a prescription for Trazodone, better take some Valium, too. So, you can see how counteracting the side effects of the last drug is another way to add another drug. The sad, criminal part, in my opinion, is that there is no scientific studies in the animal labs that has ever been tested on two drugs, much less three or four. We don’t know what the drug-drug interactions are of these at the molecular level of the brain. So, there’s no safety studies—short term or long term—about any combination of two drugs. So, these are massive experiments on humans and we’re not even monitoring it, you know. So, people are on six drugs, we have no idea how safe that is, but what’s going on in the heart—
RM: And that’s common, six drugs.
GK: Yeah. Common. They’re probably—so, nursing home patients, we talked about the elderly. They don’t have any control over what—they don’t have the wherewithal to say, “No, I’m not taking that.” They’re probably zoned out already,
RM: Oh, yes.
GK: And they just swallow what the nurse gives them. The obedience thing. We respect authority—well, elderly people who were more likely raised in punitive households, you know, lots of punishment, oftentimes. And they learned to obey their elders, you know, or else. You don’t want to get punished, so they were obedient. And they tend to accept what the experts say. “My doctor must know what he’s saying and what he’s doing.”
RM: Well, they think they’re being taken care of, don’t they?
GK: Yeah. They regard that as treatment, you know. They need treatment for my sadness, so where do they go? They go to a doctor or a psychiatrist that offers them “treatment”. Well, if the treatment is harmful, the doctor took the Hippocratic Oath, “first, do no harm”. In defense of physicians, you know, we don’t know—we are not told by the drug companies who propaganda these drugs on us, that we don’t know the whole picture. We just sort of believe that authority figure. Doctors are obedient to the drug companies. And the patients are obedient to the doctors, so the patients are being obedient to the unknown nebulous corporations that want them to take the medication.
RM: So, the cycle is the elderly get on medications for physical problems, perhaps something like high blood pressure, and then that leads to depression and then that leads to antidepressants and an assortment of other drugs. And how does it affect things like short term memory and, you know?
GK: Adversely affects it, for sure. You know, it’s affecting the brain. Might, you know, if you’re on a psychostimulant drug, it maybe enhances memory, you alert and that sort of thing, but maybe also not sleeping as well. Well, then you’ve got sleep deprivation coming in there, too, and then that gets treated with something else. That’s just one scenario, you know. There’s all sorts of other scenarios. What happens if someone gets on a diabetes or a blood sugar lowering medication? Those haven’t been tested on the effect on the brain. But they’re small molecules and they certainly get into the brain. Lipitor, you know, that’s usually popular in the best-selling, most profitable drug for Pfizer that there ever was, I guess. But that causes amnesia in some cases, causes depression in some cases, etcetera. It has a lot of side effects. But the drug industry is not obligated to figure out what it does to the brain. They figure out what it does in the liver. They know a lot about what Lipitor does to the liver. But they don’t study what effect it has on the brain. And yet, it gets into the brain. So, when this huge list of side effects in the Physician’s Desk Reference, the PDR, but they never explain why does it cause nausea? You know, they might understand why Prozac helps with depression short term, theoretically why it works, but all these nausea and sexual dysfunction that are so common, they don’t have to explain why it does that, you know. There’s no even theory as to why it does that. Just a side effect. But it’s having some effect on other cells in the body, other organs systems in the body. And they are not required by the food and drug administration to explain the side effects. Scary.
RM: It is. Thanks so much.
GK: Yeah, you’re welcome.
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