Q. What can you tell me about medication used to fight alcoholism? I am getting out of prison soon, and I need all the help I can get. My four kids need it just as much as I do.
How would I get it and how much will it cost? I don’t have much money.
A. The prescription medications used to treat alcoholism work best in conjunction with counseling and social support. ReVia (naltrexone) has been available for some time and takes away the pleasurable feelings associated with alcohol. Sadly, the drug is quite expensive (over $200 for a month’s supply) and there is no patient assistance from the manufacturer.
Campral (acamprosate) is relatively new and seems to affect brain chemistry by helping people avoid alcohol once they have quit. It too is expensive (over $115 for a 30 day’s supply). Fortunately, the manufacturer (Forest Labs) does have a patient assistance program. Your doctor will need to fill out an application for you to receive free medicine.
Q. Recently I experienced two rather worrisome events–the total loss of vision for a minute or two and occasional double vision. My MRI and MRA were fine but my doctor concluded that Viagra was causing these visual problems. I have taken it once or twice a week for quite some time. He told me that if I continue using it, I might have a total loss of vision. If this is indeed the case, would Cialis or Levitra be an alternative?
A. The FDA has warned patients that a loss of vision associated with Viagra, Cialis or Levitra could be an early warning sign. Some men taking these drugs have become blind as a result of NAION (non-arteritic anterior ischemic optic neuropathy). This condition occurs when blood can’t flow easily to the optic nerve. You may want to talk to your doctor about alternative approaches to erectile dysfunction.
We are sending your our Guides to Treating Sexual Dysfunction and Drugs That Affect Sexuality for more information on other ways to deal with ED. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. YP-96, P. O. Box 52027, Durham, NC 27717-2027.
One possibility may be alprostadil. It can be injected or inserted into the urethra. A cream (Alprox-TD) improved erections for over 50 percent of the men in a clinical trial. This topical form has not yet been approved by the FDA.
Q. I have heard that people with diabetes need to be careful about fish oil supplements. The capsules can raise blood sugar. Please tell me if this is true. My doctor doesn’t know anything about it.
A. Norwegian scientists recently reported the results of a study of type 2 diabetics given high doses of fish oil (6 grams per day) (American Journal of Clinical Nutrition, Sept. 2006). The diabetics on fish oil had lower insulin sensitivity and higher average blood sugar.
Even though fish oil may be beneficial for most people, these findings suggest that high doses pose a problem for diabetics. Lower doses, such as one gram daily, might be fine.
Q. Have you ever heard of using Reglan to enhance breast milk production? Are there any side effects?
A. Reglan (metoclopramide) is prescribed for serious heartburn (reflux). It appears to increase breast milk production, but this is an unofficial (off-label) use. Side effects may include drowsiness, restlessness, fatigue, insomnia and depression. Reglan gets into breast milk.