A doctor has revealed the medications he avoids prescribing to his patients, including an antidepressant taken by millions of people.
Dr. Ahmed Abd Elbary, a UK GP, told his 291,000 followers on tiktok that some medications “don’t work very well” and others simply have “too many side effects.”
In the video, which has racked up 4.5 million views, he said there are often much better alternatives to prescribing.
One of the medications listed by Dr. Ahmed is citalopram, a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).
It can cause side effects such as fatigue, nervousness, dry mouth and sweating, but that does not mean Dr. Ahmed avoids prescribing it.
Instead, he claims that there are better alternatives to treating depression.
He said: “I don’t have a particularly big problem with citalopram; the only thing is that there is a much better alternative called escitalopram, which studies have shown works much better in treating depression and I found it in my own clinical practice.”
There are some differences between the two medications, such as twice as much citalopram is needed to have the same effect as escitalopram.
Escitalopram may also be helpful for anxiety and is also used to treat social anxiety disorder and obsessive-compulsive disorder (OCD), as well as depression, according to the NHS.
Dr. Ahmed also avoids another medication, gabapentin, which is taken to treat nerve pain and epilepsy.
“The problem I have with gabapentin is that there is no real evidence that it really works that well for pain,” he said.
He added: ‘Even when it works, the doses needed are very high. So, most of the time, people take it for many years, increase the dose every few months and all it does is make them drowsy, cause confusion and reduce their memory.’
Feeling tired and sick, swelling of the arms and legs, dry mouth and blurred vision are just some of the long list of common side effects caused by the drug, according to the NHS.
The third drug Dr. Ahmed mentioned is sumatriptan, a medication used to treat migraines and cluster headaches.
However, Dr. Ahmed prefers zolmitriptan, another type of medication known as triptan that works to relieve headaches in a slightly different way.
“You need a lower dose and it’s much more effective,” he said.
In the video, which has accumulated 4.5 million views, he admitted that in some cases there are usually better alternatives to prescribing.
Triptans are usually given in cases where pain relievers do not work. They have a different mechanism of action than pain relievers and work by mimicking the action of a brain chemical called 5-hydroxytryptamine, also known as serotonin.
Bursts of the hormone, known to improve mood, can cause headaches due to its effect on blood vessels in the brain.
one 2000 study showed that 2.5 mg and 5 mg of zolmitriptan were as effective as 10 times the dose of sumatriptan in treating migraines.
Other doctors have recently taken to social media to warn about the risks of commonly prescribed medications.
Dr. Zain Hasan, a Los Angeles-based anesthesiologist, told his 635,000 followers on TikTok that there are at least five medications linked to dementia, including some antidepressants, pain relievers and allergy medications.
He explained that long-term use of antihistamine medications used to help relieve allergy symptoms, as well as anticholinergics, which are also used to treat allergies, have been linked to dementia.
Deborah Grayson, a prominent pharmacist, also said that proton pump inhibitors (PPIs), used to relieve acid reflux, could trigger depression.
PPIs are a type of medicine that helps reduce stomach acid and are one of the most commonly taken medicines in Britain, with more than 74 million prescriptions in England alone in 2023.
But they can also cause symptoms of depression among those who take them.
This is because PPIs, such as omeprazole and lansoprazole, can prevent the body from properly absorbing vitamin B12, a vital nutrient found in meat, fish, dairy, eggs and some fortified cereals. and that keeps the nervous system healthy.
Lack of it is a known cause of psychological problems which, according to the NHS, can range from “mild depression or anxiety to confusion and dementia”.