Q. I am in my early 60s and in good health. I ride a bike daily, work out at the gym, and my doctor says my cholesterol and blood pressure are great.
A difficult divorce resulted in my doctor prescribing an antidepressant, which helped with my mood, but has ruined my sex life. My libido is low, my erections are weak, and I cannot achieve an orgasm.
I am engaged to a beautiful woman who loves sex and is very enthusiastic. She blames herself for my lack of interest, but I think the drug is to blame. Are there any antidepressants that don't result in sexual side effects?
A. Many antidepressants (including Paxil, Prozac, Zoloft, etc.) can lower sex drive, cause impotence or delay orgasm. Ask your doctor about two alternatives. Wellbutrin (bupropion) and a brand-new patch called Emsam (selegiline) are far less likely to result in sexual dysfunction.
You may also want to invest in a different bike seat. Evidence is accumulating that pressure from ordinary bicycle seats can damage delicate nerves and interfere with erections.
Q. I have learned recently that people with soy allergies should avoid Atrovent. Why?
My best guess is there is a soy component to the mist. What's the real answer?
A. You are correct. Atrovent, an inhaled medicine used to treat breathing difficulties, contains soya lecithin. People who are allergic to soy or peanuts must avoid this medicine, as it could produce a life-threatening reaction.
Q. My mother is 78 and was in good health. Her cholesterol was a little high (180-200), though, and her physician prescribed Crestor.
Within a month, she was experiencing leg pain so serious that she could not stand long enough to put lunch dishes in the dishwasher. She complained, and the doctor switched her to Vytorin.
I stay with her at night since my father died. She has to get up several times a night with leg pain or cramps. She also has this pain during the day. Her doctor told her to take ibuprofen for it.
I am concerned that there is a link to the cholesterol medicine and her leg pain, though I know it might be a coincidence. She asked him again on her last two visits, and his response was, "You're getting old."
I don't like that attitude and worry that she is suffering unnecessarily. Maybe the cure is worse than the medical problem!
A. Older people may be more vulnerable to side effects such as muscle pain due to a statin cholesterol-lowering drug. In addition, they might not get as much benefit as expected. Given your mother's good health and age, lowering her cholesterol below 180 may be counterproductive if she can't get around because of pain.
We are sending you our Guides to Cholesterol Lowering Drugs and Leg Pain for more details on these issues, along with a drug-safety questionnaire. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (63 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. LQR-835, P.O. Box 52027, Durham, NC 27717-2027.
Q. I have a problem with sweaty armpits no matter how much deodorant I use. Are there any home remedies that can help?
A. Try applying milk of magnesia to your underarms. Readers tell us this laxative is effective for both odor control and sweating. Certain Dri might also help. Otherwise, ask your doctor about a prescription for Drysol.
Q. My doctor prescribed tramadol with APAP for headaches. He also wrote prescriptions for Lexapro and Effexor for depression and anxiety. He said that Effexor and Lexapro are both antidepressants, but they work on different parts of the brain.
When I went to fill the new Lexapro and refill the tramadol prescription, the pharmacist would not fill them. She said the combination could cause side effects. What would those be?
A. Your pharmacist might have saved your life. The combination of Lexapro, Effexor and tramadol (Ultram) could have raised serotonin to dangerous levels (serotonin syndrome). In such situations, people may experience symptoms such as anxiety, agitation, muscle twitches and contractions, sweating, high blood pressure, confusion, hallucinations, convulsions and even coma.
Q. Three years ago, you ran a letter from someone who said that patting cornstarch on her face with a cotton ball had helped her rosacea. I'd like to thank that person. I've tried many products through the years, without much success, but the cornstarch works better than anything. What a simple, cheap remedy!
A. Thanks for sharing your interesting experience. Another reader reported: "I have had rosacea -- dry, flaky reddened facial skin -- for years. I decided to try vinegar as a facial cleanser. I dampen a cloth with it and wipe my face once daily. My facial skin has not felt this smooth or been this free of redness for a long time."
People who don't find such home remedies helpful might be pleased to learn that the Food and Drug Administration recently approved a new prescription drug for this hard-to-treat skin condition. Oracea contains a special low-dose formulation of doxycyline (40 mg). Results from clinical trials indicate that Oracea has anti-inflammatory activity against the "pimples" of rosacea and does not seem to trigger antibiotic resistance or typical side effects. Oracea should reach pharmacy shelves in July.
Q. My friend is diabetic and suffers terribly from nerve pain in his legs. What can you tell me about ways to treat this problem?
A. Diabetic nerve pain (neuropathy) can be debilitating. The burning can be unbearable, and the loss of feeling in feet is dangerous.
A drug called Lyrica is approved for treating this condition. Side effects may include dizziness, drowsiness, weight gain, blurred vision, fluid retention and dry mouth. The antidepressant Cymbalta has also been shown to help ease diabetic neuropathy. Adverse reactions to watch for include nausea, dizziness, drowsiness, constipation, dry mouth and increased sweating.
Another option may be alpha-lipoic acid. This natural antioxidant, available at health-food stores, has been shown to help reverse symptoms for some people.
We are sending you a one-hour CD of a radio interview we conducted with experts in diabetes care. They discussed the latest drug treatments for diabetes and neuropathy as well as diet controversies. Anyone who would like a copy of this CD may send $16 to: People's Pharmacy (CD-526), P.O. Box 52027, Durham, NC 27717-2027 or visit our Web site, www.peoplespharmacy.com, and look for radio show No. 526.
Q. Have you heard of any commercial formulation of diphenhydramine and ibuprofen? I'm hoping for something with anti-inflammatory activity.
A. Advil PM contains ibuprofen plus the antihistamine diphenhydramine. You could also buy both drugs separately as generics.
In their column, Joe and Teresa Graedon answer questions from readers. E-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is "The People's Pharmacy Guide to Home and Herbal Remedies" (St. Martin's Press).