These days, when a full 61 percent of adults use at least one medication to treat a chronic health problem, many people expect a prescription at every doctor's appointment. (And doctors are often all too happy to oblige.) Since every drug has side effects and may interact with other meds, though, you shouldn't just swallow any pill ordered without a second thought. First ask:

1. WHY AM I GETTING THIS DRUG?

Place the emphasis on the "I." Your doctor should consider your personal risk factors when prescribing a drug, not the experience of the patient he/she treated earlier who may have been helped enormously, but also may have been far sicker.

2. WHAT ARE THE RISKS VS. THE BENEFITS?

Your doctor should be able to tick off the side effects and any serious adverse effects of any drug he/she is prescribing. You should also have a clear understanding of the benefits. Even in severe cases of depression, antidepressants significantly help just one third of patients, mildly help another third, and don't do much good for the remaining third. This information isn't featured prominently on manufacturers' websites.

3. IS THERE AN OLDER DRUG OR LIFESTYLE ALTERATION THAT WORKS JUST AS WELL?

With a new medication, "We might not know its long-term benefits or its track record for risks," explains Lisa Schwartz, an associate professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. "It's one thing if there's no other treatment available for your condition, but it's quite another if there are a lot of other treatments that have stood the test of time."

If your doctor can't make a strong case for why a new treatment may be better, take the older one, says Schwartz. For people with mild depression, for example, exercise can work just as well as an antidepressant. And salt-sensitive folks with high blood pressure may be able to reduce hypertension simply by lowering their sodium intake.

4. WILL IT INTERFERE WITH MY OTHER MEDICATIONS?

Many people get their prescriptions from different specialists who don't check for interactions. And pharmacies may not alert you to dangerous interactions if you don't get all your medications from the same place.

5. DOES THIS DRUG PREVENT REAL CLINICAL EVENTS?

"It's not enough to show that a drug lowers blood sugar," says Steven Nissen, head of cardiology at the Cleveland Clinic, Cleveland, OH. "Does it, in fact, improve clinical outcomes and not cause harm?"

Nissen's study three years ago showed that Avandia was associated with an increased risk of heart trouble. Your doctor should be able to tell you what the odds are you'll have a bad outcome if you don't take a certain drug.

 

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