Drugs and Supplements

Do any supplements effectively lower cholesterol?

DEAR DOCTOR K: My cholesterol is high and my doctor wants me to go on a statin. I'd like to avoid medication. Do any supplements effectively lower cholesterol?

DEAR READER: Statin drugs lower LDL (or "bad") cholesterol and also reduce inflammation. Together, these effects lower your risk of heart attack. Various herbs and supplements have been touted for their ability to improve cholesterol levels. There is one general caveat you should consider. New drugs are tested by the FDA for their safety, effectiveness and purity.

What can I do to prevent migraines?

DEAR DOCTOR K: I suffer from excruciating migraine headaches. What can I do to prevent them?

DEAR READER: Migraines are severe, throbbing, often debilitating headaches. They can be accompanied by nausea or vomiting. It's no wonder that anyone who suffers from migraines would do anything to avoid them. Migraines can be triggered by certain activities, foods, smells or emotions. Common migraine triggers include:

How can I get my elderly mother to take her medications consistently?

DEAR DOCTOR K: My mother is supposed to take several medications each day, but she doesn't take them consistently. What can I do to get her back on track?

DEAR READER: I'll bet when you were a kid and your parents were hounding you about taking your medicine, you never imagined a day would come when you'd be doing the same to them. Nearly three out of four Americans report that they do not always take their medication as directed. So there are a lot of people who are in the same position as your mother. And, obviously, for the medicines to work, a person's got to take them.

Are there any new treatments for lowering cholesterol, besides statins?

DEAR DOCTOR K: I have high cholesterol, but I can't tolerate statins. Are there any new treatments for lowering cholesterol?

DEAR READER: I assume you're taking statins because your low-density lipoprotein (LDL) cholesterol (so-called "bad" cholesterol) is high. If so, that does increase your risk of having a heart attack or stroke. Lowering LDL cholesterol reduces that risk. Some people can bring down their cholesterol levels with diet and exercise alone. But many people need medication to get to their target levels.

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.