Q. I have taken Prozac, Paxil and Zoloft, each for an extended time (not together). Although I was taking the recommended dosage, I did not benefit from any of them. Is there anything else on the market that will help depression? My doctor seems more concerned with my cholesterol than with my depression.
A. There are many antidepressants on the market, but you might want to discuss fish oil with your physician. A study published in the Archives of General Psychiatry (Oct., 2002) demonstrated benefit from 1 gram of fish oil daily in patients who had not responded to antidepressants. As a bonus, fish oil may actually help lower triglycerides and cholesterol.
Q. Many doctors today double the dose of the pills they prescribe so that patients can split them in half. This allows us some relief from the atrocious prices we are charged.
How does this affect the medicine? If my car holds 20 gallons of gas and I put only 10 gallons in it, I can only go half as far. So, if I split a 20 mg pill, does it only work half as long?
A. Splitting pills should not affect the length of time they last in the body. Whether a doctor prescribes a 5 mg Valium or a 10 mg pill that gets split in half, the outcome should be the same.
This does not hold true, however, for medications that are long acting or extended release. The special formulation of those pills makes them inappropriate for splitting. Be sure to check with your doctor and pharmacist to make sure pill splitting is a safe way to save money.
Q. I hope you can give me a straight answer since my physician and pharmacist don’t seem to agree. I take Zestril and Norvasc for high blood pressure and Zocor for a cholesterol problem. I am plagued with a constant cough that wakes me up at night. Cough medicine doesn’t help and my pharmacist says it is the Zestril. My feet and ankles have also started swelling so I can’t get into my shoes.
I’ve been told that grapefruit will interact with my medicines. But my doctor says that I would have to drink more than a quart of grapefruit juice a day to cause a problem. What is the deal on grapefruit, and could it be responsible for any of my problems?
A. ACE inhibitors like lisinopril (Zestril, Prinivil), enalapril (Vasotec) or quinapril (Accupril) can cause a persistent cough in some people. One reader reports, “For the past two years I had a chronic cough that was variously diagnosed as allergies, sinus or acid reflux. I was taking lisinopril for my blood pressure. When I read that coughing could be a side effect, I checked with my doctor. He switched me to Cozaar. Within less than a week’s time, the coughing subsided. I now sleep straight through the night without being wakened by coughs.”
Grapefruit may interact with Zocor. People vary in their response, but research has shown that an eight-ounce glass of grapefruit juice can raise blood levels of many medications, including Zocor.
We are sending you our Guides to Blood Pressure Treatment and Grapefruit Interactions so you can discuss this issue with your doctor. Anyone who would like copies, please send $4 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. BJ-79, P. O. Box 52027, Durham, NC 27717-2027.
Norvasc can cause swollen ankles. Please discuss this and your cough at your next visit.
