Medication Cascade

A prescribing cascade occurs when a side effect from one drug is treated with an additional medication rather than reassessing the original drug. Medications frequently produce side effects that are treated with additional medications, creating a self-reinforcing cycle that drives prescription counts upward. The article identifies prescribing cascades as a major contributor to extreme medication lists in older adults. The medications prescribed in assisted living primarily treat symptoms rather than underlying disease, and many of those symptoms are themselves side effects of prior medications or diet. Some medication lists include drugs prescribed to treat side effects from earlier prescriptions. The cascade ultimately benefits pharmaceutical companies while leaving patients chronically ill, as the root dietary cause is never addressed. The prescribing cascade can cause medication lists to grow over time.