Your Health ;
ferent drugs prescribed for the same patient
by different doctors; drugs prescribed for uses
that the Food and Drug Administration has not
approved; and an imperfect testing system
for new drugs, which permits the marketing
of medications that only later prove to have
harmful side effects.
Moreover, drugs are widely assumed to be
designed to target a specific medical issue, but
they rarely do. “They have effects on multiple
organs,” says Schiff. “These are very complex
molecules going into very complex organ sys-
tems of human bodies.”
That’s especially true for older people. “As
we age, changes occur to all organ systems, and
these can affect the way that medication is pro-
cessed in the body,” says Mary Ann Zagaria, a
consultant pharmacist in Norwich, N. Y., and a
board member of the Commission for Certifi-
cation in Geriatric Pharmacy. “A drug regimen
that was appropriate for a 60-year-old would
not necessarily be well tolerated at 70 or 80.”
More than 75 percent of Americans age 60
and over take two or more prescription drugs,
and 37 percent use at least five, according to
‘There are a lot of
people taking drugs
to treat the side
effects of drugs.’
—Gordon Schiff, M.D.
Harvard Medical School
the federal Centers for Disease Control and
Prevention. But older people are rarely included in clinical trials, which test a drug’s safety
and effectiveness.
One reason older people are excluded is
that the specific effect of a new drug can be
“harder to tease out” when tested on people
who are likely to have other medical conditions, says Michael Steinman, M.D., an associate professor at the University of California
in San Francisco. “But also, from a drug company’s perspective, it’s advantageous to study
a drug in younger, healthier people who are
less likely to have side effects.” The result, he
adds, is that doctors are “handicapped” by not
knowing “how well these drugs work in older
and sicker people who most often need them.”
Drug manufacturers spend billions of dollars
persuading doctors to prescribe—and older
