Q. Have you ever heard of eating orange peel? After almost every meal I eat, especially after eating something sweet, I get a craving for orange peel. It seems to satisfy some unknown dietary need in my body.

Is orange peel toxic in any way? Could craving it be a sign of a hidden deficiency in my diet or a psychological habit I have acquired? I hope you can help me solve this mystery, since none of the doctors I have consulted has known the answer.

A. Orange peels may be treated with fungicides or other chemicals to help improve shelf life. That’s why we’d discourage you from eating very much of it.

Your food compulsion is reminiscent of others. Readers have shared overwhelming urges to eat carrots, tomatoes, clay, dirt or even laundry starch. It is quite possible that this condition, called pica, is related to a mineral deficiency.

One woman shared the following: “Several years ago I developed a strong craving to crunch on ice. I would always have a cup of crushed ice to eat until I read that craving ice could be a sign of iron deficiency. My doctor suggested iron pills, and in two months my craving for ice disappeared.”

Please ask your doctor to perform a blood test to see if you are anemic. Both iron and zinc deficiencies have been associated with pica.

Q. I have taken a number of antidepressants over the last several years including Celexa, Zoloft, Paxil and Remeron. They work but I don’t like the side effects. I’ve experienced dry mouth, insomnia, dizziness, excessive perspiration and nausea at different times.

I would like to try St. John’s wort as an alternative, but I don’t know anything about side effects or dose. Any information would be appreciated.

A. St. John’s wort remains controversial. Although several studies have shown that the herb is comparable to prescription medications for mild to moderate depression, it has not fared well against severe depression. Only your doctor can determine if St. John’s wort would be appropriate in your situation.

The usual dose is 300 mg of standardized extract three times a day. Side effects are generally mild and less common with this herb than with prescription antidepressants. Digestive upset is occasionally reported. Since St. John’s wort can interact with many other medications you should do your homework before adding it to any other drugs.

We are sending you our Guides to Psychological Side Effects, Antidepressant Pros & Cons and St. John’s Wort, so you will have more information on this issue. Anyone who would like copies may send $3 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. MVX-227, P. O. Box 52027, Durham, NC 27717-2027.

Q. Is Provigil effective for ADD? I am in the Army. Is this drug safer than amphetamines for times when sleep deprivation is necessary?

A. Provigil is not FDA-approved for attention deficit disorder, but a few studies suggest that it might be effective. The drug is used for narcolepsy, a condition in which people fall asleep unexpectedly during the day.

Because Provigil has stimulant activity, it has been used by the armed forces of several countries (including the French Foreign Legion) to keep key personnel alert during covert operations. Side effects may include headache or nausea.

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