When patients seek medical advice, they rely on their doctor’s expertise to diagnose conditions accurately and recommend the best treatments. While many people research their symptoms beforehand, the final decision on which medication to prescribe rests with the healthcare professional.
Doctors follow strict prescribing guidelines but often have multiple options to treat a condition, depending on the patient’s symptoms, existing treatments, and clinical judgment.
Dr Asif Ahmed, a UK-based general practitioner, recently shared on TikTok the three medications he tends to avoid prescribing. According to him, these drugs either lack sufficient effectiveness, cause undesirable side effects, or have better alternatives available.
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Gabapentin, an anticonvulsant commonly prescribed for nerve pain associated with conditions like shingles and diabetic neuropathy, is one of the medications Dr Ahmed is cautious about. While gabapentin is also used to manage epileptic seizures, he specifically referred to its role in pain relief.
He explained, “The issue I have with gabapentin is that there’s no solid evidence it works very well for pain. Even when it does, the required doses are high. Patients often stay on it for years, with increasing doses, resulting mainly in drowsiness, confusion, and impaired memory.”
The NHS website indicates gabapentin may alleviate pain by affecting the transmission of pain signals in the brain and spinal cord, but does not comment on its overall effectiveness for all patients. While most users do not experience side effects, fatigue and dizziness are possible for some.
Citalopram, a selective serotonin reuptake inhibitor (SSRI) prescribed for depression and panic attacks, is another medication Dr Ahmed prefers to avoid—not due to safety concerns but because he favors an alternative.
He said, “I don’t have major issues with citalopram, but there is a superior alternative called escitalopram. Research shows it works better for depression, and my clinical experience supports this.”
Sumatriptan, often prescribed for migraines and cluster headaches, rounds out the list. Migraines are believed to involve temporary dilation of brain blood vessels, and sumatriptan acts to constrict these vessels to relieve symptoms.
Dr Ahmed noted, “For migraines, I prefer zolmitriptan over sumatriptan. It requires a lower dose, tends to be more effective, and can also treat migraines triggered by menstrual cycles.”
Patients should always consult their GP before starting or switching medications. Careful evaluation ensures treatment is tailored safely and effectively to individual needs.