Q. My daughter still wets the bed at age six. She has been seen by a urologist who didn’t find anything wrong. Needless to say, she is extremely embarrassed about this situation. She can’t sleep over at a friend’s house and it’s awkward to explain why.
She has been taking Ritalin for ADD this year. It has helped her concentration, but I don’t know if it contributes to the bed-wetting. Our doctor recently prescribed imipramine to see if it would solve that problem. It seemed to help for a few days. I stopped giving it to her, however, because it seemed to make her irritable. I worry that taking both drugs every day might have lasting effects on her. Is there an approach that minimizes medications?
A. When Ritalin (methylphenidate) and the antidepressant imipramine are taken together, blood levels of imipramine may be higher than expected. This could lead to side effects such as insomnia, nervousness, digestive upset and irritability.
Sleep expert Martin Scharf, Ph.D., suggests reducing snacks and drinks (especially caffeinated soft drinks) in the evening. He also recommends bladder stretching exercises by asking the child to delay urinating during the day for gradually increasing periods. Your daughter should go to the bathroom just before bedtime and then you should wake her an hour later to pee again.
A wetness alarm (DRI Sleeper, Nature Calls, Wet-No-More) that sounds a tone at the first hint of urine can be helpful. She should be rewarded for each dry night. Be patient, as it may take several months to see improvement.
Q. My doctor prescribed Zocor last year, and within a few months I started having weakness in my legs. I could hardly get up the stairs to my house. My arms also got very weak. I have an iron skillet I’ve used for decades, and I had to use both hands to pick it up.
What really alarmed me was forgetting names. I would see people I’ve known for a long time, but fail to remember their names. I asked my doctor if I could go off Zocor, and now I am feeling stronger and remembering things much better.
The problem is, my cholesterol has gone back up. How else can I get it down without these side effects?
A. We’ve heard from others who experienced muscle weakness, pain, or troubling memory problems while taking drugs like Zocor, Lipitor, Lescol or Pravachol. These “statin” drugs are extremely effective for lowering cholesterol, but some patients react badly. Other side effects may include nerve pain (neuropathy) and sexual dysfunction.
There are many ways to lower cholesterol and other risk factors for heart disease. New medicines like Tricor and WelChol should not cause the kind of side effects you experienced. Psyllium, fish oil and niacin are other options to discuss with your physician.
We are sending you our Guides to Heart Health and Cholesterol-Lowering Drugs to help you prepare for that chat. Anyone who would like copies, please send $3 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. CL-75, P. O. Box 52027, Durham, NC 27717-2027.
Q. As a diabetic I have had difficulties with erections. Will Viagra work and when do you take it?
A. Viagra often works for diabetics. It is taken about an hour before sexual activity.
The People's Perspective on Medicine