Antidepressant Can Raise Cholesterol

Q. I received your Guide to Heart Health. It contained a list of medications that have a negative effect on blood lipids, and I was shocked to read that one of those medications was Effexor.
Where does that information come from? My physician told me to find out so he can investigate it further. I am on Effexor to treat depression and have elevated cholesterol. It recently hit 300, and I need to get it down.
A. Your doctor will need to look no further than his PDR (Physicians’ Desk Reference). The official prescribing information states that 8 percent of patients on Effexor experience a significant increase in cholesterol to 260 or more.
A surprising number of medications can actually raise blood cholesterol. Even some blood pressure pills, intended to lower heart attack risk, can have this effect. Our Guide to Cholesterol and Heart Health lists some of these and offers alternatives less likely to affect lipids. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. C-8, P. O. Box 52027, Durham, NC 27717-2027.
Q. I frequently suffer from cold sores. They are painful and ugly. People tend to stare, which makes me very uncomfortable and self-conscious.
I have tried a variety of over-the-counter products with limited success. What can you recommend?
A. Cold sores are caused by the virus herpes simplex-1. Prescription anti-viral medicines work well to speed healing or prevent frequent outbreaks. You may wish to ask your doctor about drugs such as acyclovir (Zovirax), famciclovir (Famvir), penciclovir (Denavir) or valacyclovir (Valtrex).
Some people take the amino acid l-lysine at a dose of 500 mg daily to prevent cold sores. We are not aware of adverse effects associated with l-lysine, but we have not seen long-term well-controlled studies.
Q. I have read a lot lately about the dangers of HRT. What is never mentioned is that hormones like Prempro are not natural for women. Premarin is natural for pregnant mares and Provera is not natural for anyone because it is a synthetic chemical.
I have been using bio-identical hormones for several years with great results. I have no hot flashes and feel young again. Why don’t you recommend this approach?
A. Bio-identical hormones are exactly the same chemically as those made by the human body. You are correct that the hormone mix in Prempro is not identical to the hormones made naturally by women.
For women past menopause it is not natural to have high levels of estrogen or progesterone in any form. Some people claim that bio-identical hormones are safer than other HRT regimens. There have not been large, long-term studies of such compounds, however.
Until we have more data we cannot say whether bio-identical hormones are less likely to cause breast cancer, uterine cancer, heart attacks or strokes.
Q. My doctor just prescribed Levitra for erectile problems. I tried to look it up in a drug reference book, but I could not find it. Where can I get information on this medicine?
A. Levitra is so new that most reference books don’t yet have an entry for it. You can read about it and other medications on our Web site (www.peoplespharmacy.org). Search under the heading RxList.