When visiting a general practitioner for medical concerns, patients typically trust the professional judgement of their doctor regarding diagnosis and appropriate treatment options. While some individuals might conduct preliminary research before appointments, the ultimate decision about medication prescriptions generally rests with the medical practitioner overseeing the case.
Professional Prescribing Practices
Medical professionals must adhere to established guidelines and ethical codes when prescribing medications to patients. However, within these frameworks, doctors often have multiple treatment options to consider based on individual symptoms, existing medications, and their clinical experience. One UK-based general practitioner has recently shared insights about three specific medications he consistently avoids prescribing to his patients, believing superior alternatives exist for these treatment scenarios.
Doctor's Medication Concerns
General practitioner Asif Ahmed recently discussed his prescribing preferences in a video shared on social media platform TikTok. The doctor explained his reluctance to prescribe certain medications, highlighting what he perceives as limitations in effectiveness, problematic side effect profiles, or the availability of better therapeutic options.
"These medications either don't work very well, have too many side effects, or there's a better alternative," Dr Ahmed stated regarding his approach to these particular prescriptions.
Three Medications and Alternatives
1. Gabapentin for Pain Management
Gabapentin functions as an anticonvulsant medication primarily prescribed for nerve pain associated with conditions like shingles and diabetes, alongside its application in controlling epileptic seizures by reducing abnormal electrical brain activity. While the NHS acknowledges gabapentin's potential to block pain signals travelling through the nervous system, Dr Ahmed expressed reservations about its effectiveness for pain relief specifically.
"The issue I have with gabapentin is there's no real evidence that it actually works that well for pain, and even when it does work, the doses you need are so high," the doctor explained. "Most of the time, people stay on it for many years, get the dose increased every few months, and all it does is make them sleepy, cause confusion, and reduce their memory."
Although the NHS website indicates most gabapentin users experience minimal side effects, it does acknowledge potential issues including tiredness and dizziness for some patients.
2. Citalopram for Depression
Citalopram serves as a selective serotonin reuptake inhibitor antidepressant commonly prescribed for depression and panic disorders. The NHS notes this medication typically presents fewer side effects compared to older antidepressant alternatives. Dr Ahmed clarified he doesn't consider citalopram problematic but prefers an alternative medication he believes demonstrates superior effectiveness.
"I don't particularly have a huge issue with citalopram," the GP stated. "The thing is, there's a far better alternative called escitalopram, which studies have shown works far better to treat depression, and I have found this in my own clinical practice."
3. Sumatriptan for Migraines
Sumatriptan represents a common treatment for migraines and cluster headaches, functioning by narrowing temporarily widened blood vessels in the brain believed to contribute to migraine symptoms. Dr Ahmed expressed preference for an alternative medication when treating migraine conditions.
"My choice over sumatriptan for migraines would be something called zolmitriptan, and that's because you need a lower dose, it's far more effective, and it can be used for migraines caused during periods," the doctor explained regarding his prescribing preference.
Medical Consultation Importance
Medical professionals consistently emphasise the importance of consulting with healthcare providers before initiating, changing, or discontinuing any medication regimen. Individual medical circumstances vary significantly, and treatment decisions should always involve discussion with qualified medical practitioners who can consider personal health histories and specific needs.
For comprehensive information about health conditions and available treatments, the NHS website provides extensive resources and guidance for patients seeking to better understand their healthcare options and medication considerations.
