The question I ask is if the medication improves the quality of your life enough to accept the side effects. I realized I am fighting for my life.
I have almost always been on at least one medication to combat side effects. I think it comes down to what side effects you are actually experiencing and how disabling are they. For instance, weight gain. It varies. Some people start out small and gain a little, but their overall health isn't compromised. Others need to lose weight for their overall health before taking meds, so any gain is only making things worse. Some side effects are simply dangerous.
Finally, if not taking meds is going to leave me dead or institutionalized, I ask is the sacrifice worth it? So far seeing my kids grow up has been worth knowing the meds are not extending my overall health.
This is a great question to really sit and think about. Most avoid the topic altogether.