February 1, 1985

The Decision to 'Unmedicate'

Author Affiliations

Beth Israel Medical Center New York

JAMA. 1985;253(5):687-688. doi:10.1001/jama.1985.03350290093035

Inherent in prescribing drugs is a decision that the benefit resulting from therapy is greater than the risk associated with a given medication. A corollary of this concept should be an ongoing review of whether it is necessary to continue the administration of a particular drug indefinitely, or whether it is safe to "unmedicate" under certain circumstances. Reviews of this type have shown, for example, that adult epileptics taking phenytoin can be unmedicated with impunity in 60% of the cases.1 Another well-accepted but controversial precept of medical care concerns the role of nonpharmacologic therapy for patients with hypertension. Specifically, the effect of weight reduction and sodium restriction on the drug treatment of hypertension, and the resultant influence on morbidity and mortality, remains incompletely elucidated.

Langford and co-workers2 report in this issue of The Journal the results of a study designed to determine whether patients receiving aggressive antihypertensive therapy