Drugs and Supplements

Does long term use of antihistamines cause dementia?

DEAR DOCTOR K: I've been taking over-the-counter antihistamines for years to control my allergies. Now I hear I may have to worry about dementia. How real is the concern?

DEAR READER: Antihistamine drugs have "anticholinergic" (an-tee-cole-in-ER-jik) effects. That means that they have some tendency to block the action of a natural substance called acetylcholine. This substance transmits messages in the nervous system. In the brain, it is involved in learning and memory; in the rest of the body, it stimulates muscles to contract.

I take low-dose aspirin to prevent a heart attack. Do I need to worry about bleeding risks?

DEAR DOCTOR K: I had a heart attack several years ago. I have been taking low-dose aspirin ever since to prevent a second one. Do I need to worry about bleeding risks?

DEAR READER: Every medicine contains risks as well as benefits. The question with any medicine is: Do the benefits outweigh the risks? Aspirin helps prevent repeat heart attacks in two ways. A heart attack occurs when the flow of blood through one of the heart's arteries is blocked.

Restore sex drive by changing dose or kind of depression medication.

DEAR DOCTOR K: Last year I started taking an SSRI for depression. It has done wonders for my mood -- but it has really dampened my sex drive. Any suggestions?

DEAR READER: Since depression is so common, and since SSRIs are often used to treat depression, I've known many people who share your problem. Fortunately, there are several options that often help people restore their sexual desire and function. Selective serotonin reuptake inhibitors (SSRIs) are currently the most commonly prescribed antidepressants.

Are poop pills really used to treat diarrhea?

DEAR DOCTOR K: I overheard a colleague talking about "poop pills" used to treat diarrhea. That can't be right. Can it?

DEAR READER: Yes, "poop" means what you think it means. Same thing as "doo-doo." It's gross, but it's true. So-called "poop pills" are being used to treat diarrhea caused by bacteria called Clostridium difficile, or "C. diff." Let me explain. Our intestines are filled with many different kinds of bacteria. Most live happily there; they don't invade or attack the intestine that is their home.

How do I know if the drugs I’m taking are still necessary?

DEAR DOCTOR K: I'm in my 70s. Every day I take 10 medications, many of which I have been taking for years. How do I know if all of these drugs are still necessary?

DEAR READER: You've asked an important question. It should be a part of every medical visit for your doctor to review your medicines. There are several reasons that I say this. First, doctors' visits these days are pretty short. We often feel rushed to cover everything in the time available. Even though we should be reviewing the medicines that a person is taking, we sometimes don't.

Should I try the new FDA approved weight loss drug?

DEAR DOCTOR K: I heard about a new drug that can help people lose weight. I'm overweight. Should I give it a try?

DEAR READER: You're likely referring to Contrave, a drug the FDA approved in September of 2014 to help people lose weight along with a reduced-calorie diet and exercise. Contrave combines two drugs, naltrexone and bupropion. These drugs are already approved for other uses. Naltrexone is used to help kick alcohol and narcotic addiction. Bupropion is used to treat depression and seasonal affective disorder. Many people also take bupropion to stop smoking. Neither naltrexone nor bupropion by itself has been approved for weight loss.

Is it dangerous to have an energy drink everyday?

DEAR DOCTOR K: I have two kids and a high pressure job. I'm always exhausted. Lately, I've been drinking an energy drink in the afternoon to get through the day. My husband thinks this is dangerous. Is he right?

DEAR READER: I'm sure many readers can relate to the mid-afternoon slump. It's no wonder that energy drinks and shots have become the fastest-growing category in the beverage industry. What gives energy drinks their jolt is good old-fashioned caffeine.

How can I make swallowing pills easier?

DEAR DOCTOR K: I have a hard time swallowing pills. Do you have any suggestions?

DEAR READER: Swallowing pills can be difficult and downright unpleasant. It causes many people to gag, vomit or choke. This can keep people from sticking to their medication routines. A new study published in the Annals of Family Medicine may help. In the article, researchers suggest two techniques to help people improve their ability to swallow pills. (I've put illustrations of both techniques below.)

Is Pradraxa as safe as previously thought?

DEAR DOCTOR K: I have atrial fibrillation. For years I took warfarin. Last year I switched to Pradaxa. Now I hear Pradaxa may not be as safe as my doctor said. What can you tell me about this?

DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. It increases the risk of stroke. For decades, the best way to prevent stroke from atrial fibrillation was by taking a blood thinner called warfarin (Coumadin).

Are over-the-counter cold medications safe?

DEAR DOCTOR K: I'm in my 60s. Whenever I have a cold, I reach for whichever medication treats the most symptoms. My wife says that's not safe, even if the medication is available over the counter. Is she right?

DEAR READER: Your wife is correct. Clearly, you should listen to her more often. Painkillers, decongestants, antihistamines and combination remedies -- even those available over the counter -- can sometimes cause health problems. They can interact with other drugs and can interfere with existing conditions. When choosing a cold medication, read the list of active ingredients.