Over 30 years ago, Jocelyne Drouin Delowsky was prescribed clonazepam to treat her anxiety. She was told she would be on the drug for her entire life. At the time, the medication seemed like the best solution for her. As far as she could remember, she had always felt a certain level of anxiety. As time went on however, Jocelyne still didn’t feel quite right — despite her continued use of the medication.
She continued the drug for many years. Whenever her anxiety started to return she would take another pill. It wasn’t until Jocelyne was in her sixties that she considered stopping her use of clonazepam.
Working together with her family physician, Jocelyne was able to taper off and eventually stop her use of clonazepam. She found alternative support in therapy to help manage her anxiety. This was the right fit for her. As time went on, she found she was starting to feel more like herself, stating, “I haven’t felt better in years.”
Susan Conklin was regularly visiting her mother in a long-term care home in Eastern Ontario when, upon one visit, Susan noticed a change in her mother. Susan’s mom was no longer the lively, chatty woman she had known for so many years; a fog had descended on her mother. While some said it was natural to see such a decline in a woman who is 90 years old, Susan did not accept that her mother would change so suddenly. It took a medications review to discover what might have been the root of the abrupt turn of her condition.
Susan contacted a specialist who performed a medications review of her mother’s prescriptions and found that she was on a number of unnecessary or inappropriate medications. The tapering process was slow, carefully reducing doses to ensure that the medications were safely removed. As the unnecessary medications fell away, Susan started to get her mother back piece by piece until she finally returned to the bright and engaged woman that Susan remembered. As Susan says, “Deprescribing gave me my mom back.”
Dr. Kevin Pottie has worked with over 100 patients using the new, evidence-based deprescribing guidelines. He explains that deprescribing is accomplished gradually — over many visits, between the health care practitioner and the patient, thorough education for the patient about the illness and the drugs they are taking and why they are taking them, and a strong relationship between the health care practitioner and the patient.
Using these methods, Dr. Pottie has moved his practice away from a “culture of over reliance on drugs” and has normalized a practice that takes careful consideration of a symptom’s causes, what the best course of treatment (medication or other) is to address the symptom, and how the patient would like to be treated from their perspective.
In 2008, Judith Maxwell was an active 71-year-old who travelled south in the winter, played in a band, taught music and art, and treasured time with her family. In July of 2008, in order to manage her type 2 diabetes, a specialist increased the dose of Judith’s prescriptions and added an additional drug to her medication plan.
After increasing her doses, Judith started experiencing several unexpected symptoms including pain, confusion, irritable bowel syndrome, fatigue, depression, and more. These effects resulted in Judith being prescribed more medications — targeting the symptoms rather than the cause. By 2012, Judith needed to move closer to her sons for assistance in everyday life.
After eight years and visiting multiple health care professionals, Judith’s cardiologist informed her that the effects she was experiencing may be caused by the prescriptions she was taking and the interactions that occurred between those drugs. She made a plan to reduce and simplify her medications. Since deprescribing, Judith has picked up her tenor sax to play with her friends and is enjoying more time with her family. The experience stoked advocacy within Judith, she speaks up for patient safety whenever she can and has even appeared on podcasts about patient safety.