Drugs and Supplements

What medications treat Alzheimer’s disease?

DEAR DOCTOR K: My mother has been diagnosed with Alzheimer's disease. Can you tell me about medications that are available to treat this disease? What can and can't they do?

DEAR READER: Alzheimer's disease is a form of dementia. It often affects short-term memory early on. It then progresses to impair other cognitive functions such as thinking and judgment. As the disease advances, it can affect a person's mood and behavior. Eventually, most people lose their ability to do normal daily activities.

Can aspirin really help to prevent cancer?

DEAR DOCTOR K: I read that aspirin might help to prevent cancer. Is there anything to this idea?

DEAR READER: Open any medicine cabinet in America and you're likely to find a bottle of aspirin. Aspirin has been on the market for more than 110 years. It's an old standby for fighting fever, quieting inflammation and reducing pain. For some, it can help prevent a heart attack or stroke. And growing research points to a possible new benefit for this old friend: reducing the risk of dying from cancer.

Do I really need to take warfarin after getting a stent?

DEAR DOCTOR K: I recently had a stent placed and am now taking warfarin. I hear this medicine causes bleeding. Is it really necessary for me to take it?

DEAR READER: Warfarin is an anticoagulant, or blood thinner. It decreases your blood's ability to clot. There are times when we need our blood to form clots. If we cut our skin and it starts bleeding, or if an ulcer in our stomach starts bleeding, we need the bleeding to stop. When the blood forms clots, bleeding stops. On the other hand, some conditions tend to increase the tendency of the blood to clot.

Does the new female libido drug really work?

DEAR DOCTOR K: I am a woman in my 30s. I love my husband, but I am just not interested in sex. Will the new female libido drug help?

DEAR READER: You're referring to flibanserin (Addyi). This is the first medicine to be approved by the FDA for low libido (little interest in sex) in women. It is designed to help women who would like to increase their sexual desire, and it has been shown to slightly improve sexual satisfaction in some women. Flibanserin is only approved for pre-menopausal women. So it would be appropriate for you, but not for post-menopausal women.

Should I throw out expired medications?

DEAR DOCTOR K: Sometimes the pills in my medicine cabinet reach the expiration date. Do I really need to throw them out? They can be expensive.

DEAR READER: The two questions to ask about pills that are past their expiration date are: Do they lose their strength, and do they become toxic or harmful? There is little evidence that outdated medications become toxic or harmful. However, some drugs do lose their potency, or effectiveness, over time. The most notable is nitroglycerin, which should be replaced every six months.

Can osteoporosis medications cause bone fractures?

DEAR DOCTOR K: I'm taking a pill for osteoporosis because my doctor says that stronger bones will reduce my risk of fractures. But a friend recently told me that some osteoporosis medicines actually cause fractures. Can you un-confuse me?

DEAR READER: I know what you're referring to, and it is confusing -- even for doctors. So let me try to make it less confusing. Osteoporosis does make your bones more susceptible to fractures, and a group of drugs called bisphosphonates do successfully treat osteoporosis. These drugs include alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast). People typically remain on these drugs for years.

Will melatonin supplements help with jet lag?

DEAR DOCTOR K: My wife and I are traveling to Europe in a few weeks, and we're already dreading the jet lag. Do you think melatonin will help?

DEAR READER: Many people find that crossing several time zones makes their internal clocks go haywire. Some small studies have suggested that melatonin can help jet lag if taken a few days before and after travel. Melatonin is a natural substance released by our brain to help coordinate our circadian (day/night) rhythm. This rhythm is disturbed when we travel across time zones. Melatonin is more effective in minimizing the effects on sleep of eastward travel.

Are the new statin guidelines better than the ones they replaced?

DEAR DOCTOR K: My doctor put me on a statin in 2013 because the guidelines that came out that year said I should be on them. Are the new guidelines really better than the ones they replaced?

DEAR READER: I'm sorry you asked that question, because any answer I give will be criticized by some of my colleagues on the faculty of Harvard Medical School. This is a very controversial area, and my colleagues all have strong opinions -- just not the same one.

Do daily vitamins help you or hurt you?

DEAR DOCTOR. K: I'm a 35-year-old woman who has taken vitamin pills since I was a girl. Some people tell me they don't help, and may even hurt me. What's the truth?

DEAR READER: I'll never pretend to tell you the "truth" in this column, because I don't always know what it is. And I've seen what people considered to be the truth change. But I will give you my best current assessment of what scientific studies show. First of all, there's no question that you need vitamins. In fact, they are substances all of us need to live. In developing nations, many people are made very sick and even die because of severe vitamin deficiencies.

How can I reduce the risk of side effects of new medications?

DEAR DOCTOR K: I need to start taking a new medication to treat a recently diagnosed condition. Is there anything I can do to reduce the risk of side effects?

DEAR READER: My colleague Dr. Gordon Schiff, associate professor of medicine at Harvard Medical School, says it well: "All drugs have effects -- the ones we want and the ones we don't. The unwanted effects are known as side effects." When you take a drug, it is distributed throughout your body, to all your organs and tissues. The drug may do different things in those different organs.