Q. I have the attention span of a flea and have been diagnosed with ADD. My doctor prescribed Adderall to try and improve my ability to focus.
I don’t find that it helps very much and I worry that I may be at risk for heart problems. I do have high blood pressure. Are there safer medications I could ask my doctor about?
A. Your concerns are not unjustified. An expert panel for the FDA recently proposed stronger warnings for drugs prescribed to treat attention-deficit hyperactivity disorder. Stimulant medications such as amphetamine (Adderall) and methylphenidate (Concerta, Metadate, Ritalin) may raise blood pressure and increase the risk of heart attack, stroke or sudden death.
Since you already have hypertension, taking amphetamine could counteract the effectiveness of your blood pressure drugs. You may want to ask your physician about non-stimulant alternatives that won’t affect your heart.
Q. Your article linking cholesterol medications to memory loss was not based on evidence. There are no studies showing that these drugs have a negative effect. Instead you used letters from readers, which are not scientific. I am concerned that some of my patients may have discontinued their cholesterol medicine.
A. We agree that these drugs can be valuable in preventing heart attacks and strokes. Most people can take them without complications. Those who experience difficulties, however, deserve to have their concerns taken seriously. No one should discontinue without consulting a physician.
We have heard from hundreds of readers who have had severe muscle pain and weakness as side effects of these medicines. Many others have written about memory problems or cognitive difficulties. We have received too many case reports of transient global amnesia to ignore. In this frightening condition people temporarily lose memory of significant blocks of time.
We are sending you a one-hour CD of a radio interview we conducted with physicians who have studied this effect. Anyone who would like a copy of this CD, “The Dark Side of Statins,��? may send $16 to: People’s Pharmacy (CD-523), P. O. Box 52027, Durham, NC 27717-2027 or visit our Web site, www.peoplespharmacy.com and look for radio show No. 523.
Q. When I get a cold, it often becomes a sinus infection. The congestion is uncomfortable, but the headache is what really bothers me. Any suggestions for breaking this curse?
A. Another reader shared his approach to sinus headaches: “I use nasal saline for sinus headaches. Nasal saline was first recommended to my by my ear, nose and throat doctor. Ocean Mist is the brand-name OTC product. Xlear is a version with xylitol. Both come in small spray bottles. Generic versions of Ocean mist can be found at most pharmacies for less than $3. Xlear is about $12 per bottle.��?
Xylitol is a natural sugar with antibacterial properties. Unlike decongestant nose sprays, nasal saline is not habit-forming.
Q. You had a question from a woman suffering vaginal dryness. I am using Estring, an estradiol ring. After 18 months, I have experienced no side effects and my dryness is gone.
A. Estring is a prescription vaginal ring that releases 2 mg of estradiol over three months. It is convenient and the dose of estrogen is quite low.