Please, swallow this!
Blog Author: George Szasz, CM, MDPosted: Tuesday, February 21, 2017 - 16:56
Elizabeth, my wife, is in the depths of dementia of the Alzheimer type. She is somewhat frail, but essentially healthy aside the dreaded disease. She does require a few medications: thyroid (previous thyroidectomy), vitamin D (prevention of osteoporosis), and melatonin. “Melatonin?,” you ask. Yes, it is to reduce the symptoms of REM behavior disorder, a side effect of Alzheimer disease—relating to damage to her brainstem.
She can now sleep most nights without waking up every couple of hours with flailing legs and arms and often also vocalizing, provided that she has kept the tablet in her mouth long enough for it to dissolve (it is a sublingual preparation). The same issue arises with her other medications. In general, she tends to refuse to take the offered tablet. When she does accept it, she is liable to keep it in her mouth, even after several swallows of water, then put her tongue out and spit out the tablet, still more or less intact. Other times she may bite into the tablet and then wipe her tongue clean. Sometimes we crush a tablet and offer it in jam or peanut butter. This subterfuge works on occasion, but we cannot count on it.
So here is my request to all pill makers. Please consider the plight of millions of children, elderly persons, and persons with dementia who have problems taking their pills. Please consider the many caregivers who spend time and energy trying to administer the required medications. Could we not have alternative ways of administering medications to those who need help in this important area of medical care? And not only in human medicine, how about in veterinary medical practice as well?
Dear pharmaceutical industry, please step up to the plate!
—George Szasz, CM, MD
This posting has not been peer reviewed by the BCMJ Editorial Board.