Drugs and Supplements

Does anxiety medication cause dementia?

DEAR DOCTOR K: I'm an older woman who sometimes takes Valium or Xanax for anxiety or if I'm unable to fall asleep. I recently heard that this type of medication may cause dementia. Should I stop using it?

DEAR READER: Valium and Xanax are benzodiazepines, a type of anti-anxiety drug. Like you, many people take these drugs to calm their nerves or help them sleep. And as you've heard, a recent study raised the possibility that benzodiazepine use may lead to dementia.

Will probiotics help my constipation?

DEAR DOCTOR K: I suffer from constipation. Do you think probiotics might help?

DEAR READER: Probiotics are living bacteria found in cultured foods, like yogurt, and in dietary supplements. They have long been touted for their ability to ease digestive woes. The strongest evidence for probiotics is in treating diarrhea caused by a viral infection or from taking antibiotics. Our bodies are home to a mix of "good" and "bad" bacteria.

Should I take a joint support supplement if I have osteoarthritis?

DEAR DOCTOR K: I have osteoarthritis. It's improved some with physical therapy and weight loss, but not entirely. Should I give "joint support" supplements a try? Which ones?

DEAR READER: Your question reminds me of two of my patients. "John" was a man in his 50s whose pain from arthritis in his knees made it hard for him to play pickup basketball. Physical therapy and pain medicines helped, but not completely.

What do you think of the new statin guidelines?

DEAR DOCTOR K: My doctor never recommended statins to me, but he says there are new guidelines, and thinks that I should now start taking one. What do you think of the new statin guidelines?

DEAR READER: The new guidelines make a lot of sense, because we've learned that statins have more effects on the body than just lowering cholesterol. Statins were developed after a Nobel Prize-winning discovery in the 1970s revealed how the body makes cholesterol. Most of the cholesterol in our body is made by our body, not consumed in our food. Statins slow the production of LDL ("bad") cholesterol by the body.

What is the most effective NSAID for back pain?

DEAR DOCTOR K: I have frequent back pain. I usually take acetaminophen (the Tylenol brand), but I hear it may not be effective for back pain. Is there anything to that?

DEAR READER: If you'd asked me that question even a year ago, I would have said, "Acetaminophen works fine for most people." Lots of people are bothered by back pain. When it strikes, all you want is relief -- and fast. Many folks turn to over-the-counter pain relievers like acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDs (ibuprofen, naproxen and aspirin).

Should I switch my atrial fibrillation medication?

DEAR DOCTOR K: I've been taking warfarin without any problems for years to treat atrial fibrillation. Now my doctor wants me to switch to a different medicine. Should I?

DEAR READER: Atrial fibrillation (aFib) is a rapid quivering in your heart's upper chambers, or atria. Instead of vigorously pumping blood down into the lower chambers (the ventricles), the quivering upper chambers let blood pool inside them. As blood sits, it can form clots. If a clot gets into the bloodstream and blocks a vessel supplying your brain, it can cause a stroke. Therefore, a person with aFib needs anticoagulant (anti-clotting) drugs.

Has antibiotic use in meat and poultry contributed to antibiotic resistance?

DEAR DOCTOR K: In a recent column on antibiotics, you didn't mention their use in meat and poultry as a cause of antibiotic resistance. Hasn't this contributed to the problem?

DEAR READER: You're correct. In the United States, food-producing animals such as cattle and poultry are regularly treated with antibiotics. This has contributed to antibiotic resistance: bacteria that are no longer susceptible to antibiotics. How do bacteria become resistant? Let's say you take penicillin to treat a bacterial infection.

Do antidepressants cause weight gain?

DEAR DOCTOR K: My doctor thinks I could benefit from an antidepressant. But I've heard that antidepressants cause weight gain and I'm already overweight. Do any antidepressants cause less weight gain than others?

DEAR READER: Many of my patients have asked me that question. Like you, they were hesitating to take antidepressants because of the possibility they would gain weight. And they're right: Many antidepressants do cause weight gain in some people. The question has been how much weight gain they cause.

When should I go back on a bisphosphonate drug?

DEAR DOCTOR K: I am currently on a bisphosphonate "drug holiday." How will I know if, or when, I should go back on the drug?

DEAR READER: After menopause, loss of bone (osteoporosis) can lead to crippling bone fractures. Drugs called bisphosphonates slow bone loss. Below, I've put a table with detailed information about these drugs. But bisphosphonates can cause troubling side effects. The pills can cause burning in the esophagus. And a small number of users have developed bone loss in the jaw and in the large bone in the upper legs (the femur), causing the femur to break.

What are the differences in erectile dysfunction drugs?

DEAR DOCTOR K: Is there a difference between the drugs that are available for erectile dysfunction?

DEAR READER: Erectile dysfunction (ED) is a problem faced, to one degree or another, by many middle-aged and older men. Since sildenafil (Viagra) was launched in 1998, men have been turning to medication to help address this problem. There are currently four ED drugs on the market: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra).