Q. I have just changed jobs and my new employer does not offer medical insurance. I am presently taking Luvox for trichotillomania and Synthroid for a thyroid condition.
I am having trouble getting insurance on my own and I wonder if the Luvox might be to blame because it’s usually prescribed for psychological problems. Is there a non-drug treatment for my compulsion to pull my hair so I could stop taking Luvox?
A. People who suffer from trichotillomania have an uncontrollable urge to pull out their hair. This sometimes leaves bald spots.
Luvox belongs to the same category of drugs as Prozac and Zoloft. All help control symptoms of obsessive-compulsive disorders, including hair pulling. Insurance companies can deny people coverage for many reasons, so we can’t say whether Luvox is responsible.
Cognitive behavioral therapy may help you overcome this compulsion so that you no longer need medicine. One preliminary study suggests that St. John’s wort might also be helpful.
Q. I take several blood pressure medications including Diovan HCT, Norvasc and Toprol XL. For the last six months I have also been taking Zocor to lower cholesterol.
I believe these drugs have brought my sex life to a halt. My libido is lower than ever before and I have great difficulty sustaining an erection. Would Viagra solve this problem or are there other options?
A. Your blood pressure medications have all been linked with sexual problems in some people. Zocor and other statin-type cholesterol-lowering drugs have also been associated with erectile dysfunction (Family Practice, Feb 2002). The consequences of combining so many drugs that could impair sexuality are unknown.
For more information on this complex topic, including some blood pressure drugs that appear less likely to cause such effects, we’re sending you our Guides to Drugs that Affect Sexuality and Treating Sexual Dysfunction. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. YP-96, P. O. Box 52027, Durham, NC 27717-2027.
Viagra may help your erection problem, but it won’t improve your libido. In addition, Viagra may interact with Norvasc, so your physician should reevaluate your entire treatment regimen.
Q. Many years ago I had chronic hives. Eventually a doctor prescribed Tagamet which worked like a charm.
A few years ago, I started getting hives again. My wife reminded me of the Tagamet. It is now over the counter, and it still works.
The problem is that I now take it every day and night and need it to get a full night’s sleep. I’ve taken 6 to 8 tablets a day for quite a while with no change in dose. Are there any concerns?
A. Large doses of cimetidine (Tagamet) must be medically supervised, so please discuss this with a dermatologist who could help you discover the cause of your rash. Many studies suggest that this acid suppressor can help relieve hives, especially in combination with antihistamines.
Cimetidine can interact with many other drugs, so please don’t combine it without checking. Some people report mental confusion or impotence at high doses. You might also take extra vitamin B12 since acid-suppressing drugs can interfere with efficient absorption of this nutrient.

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