When patients seek medical advice, they rely on their doctor’s expertise to diagnose and recommend the best treatment. While many research symptoms beforehand, the final decision on prescriptions lies with healthcare professionals. Doctors must follow prescribing guidelines but often choose between multiple options based on individual symptoms, existing medications, and clinical judgment.
Dr Asif Ahmed, a GP in the UK, recently revealed three medications he avoids prescribing because he believes they are less effective or have undesirable side effects compared to better alternatives.
Dr Ahmed shared on TikTok: “These medications either don’t work very well, have too many side effects, or there’s a better alternative.”
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First on his list is gabapentin, an anticonvulsant commonly prescribed for nerve pain linked to conditions like shingles and diabetes, and also used in epilepsy management. However, Dr Ahmed expressed skepticism about its effectiveness for pain relief.
He explained, “The issue I have with gabapentin is there’s no real evidence that it actually works that well for pain. Even when it does, the doses required are very high. Patients often stay on it for years, needing dose increases, and it mostly causes sleepiness, confusion, and memory problems.”
While the NHS states gabapentin may block pain signals in the nervous system and notes that most users won’t face adverse effects, some do experience fatigue and dizziness.
The second medication is citalopram, a selective serotonin reuptake inhibitor (SSRI) widely used to treat depression and panic attacks. Although Dr Ahmed raised no major concerns about citalopram, he prefers prescribing escitalopram instead, citing stronger evidence of its effectiveness.
He said, “Citalopram isn’t problematic, but escitalopram works better for depression according to studies and my clinical experience.”
Lastly, Dr Ahmed avoids sumatriptan, a common treatment for migraines and cluster headaches. Sumatriptan works by constricting dilated blood vessels in the brain that contribute to migraines.
He prefers zolmitriptan, noting, “Zolmitriptan requires a lower dose, is more effective, and can be used for migraines related to periods.”
Patients should always consult their GP before starting or changing any medication to ensure safe and appropriate treatment tailored to individual needs.