Medications and treatments Archive

There is no evidence that so-called "bioidentical" alternatives to prescription hormones are either safe or effective.

Over the past couple of years, science has validated what many women already know: hot flashes and other symptoms of menopause can persist long after menstrual periods stop. It's also well established that estrogen—alone or combined with a progestin—is the most reliable treatment for menopausal symptoms and that, for most postmenopausal women, it is safe to take these hormones for up to five years at doses that relieve hot flashes.

But in 2002 the Women's Health Initiative reported that Prempro—an FDA-approved preparation combining synthetic estrogens with a progestin—increased the risk of cardiovascular disease and breast cancer. Since then, women have shied away from pharmaceutical companies' hormones. A third of women who use hormones for relief of menopausal symptoms are now choosing custom-mixed preparations from compounding pharmacies, according to research sponsored by the North American Menopause Society (NAMS). Women surveyed by NAMS commonly said they believed "natural" or "bioidentical" hormones from compounding pharmacies to be safer than the available FDA-approved hormones.

A Spanish clinical trial of 400 people—two-thirds of whom were women—has indicated that waiting to fill an antibiotic prescription may be a good idea for people with sniffles, coughs, sore throats, and other respiratory symptoms.

Researchers recruited volunteers who sought care for respiratory symptoms in primary care clinics throughout Spain. The volunteers were randomly assigned to four equal groups. One was given antibiotics and told to take them immediately. Another was sent home without antibiotics but told to return to the clinic if they hadn't improved after several days. The two remaining groups were told to wait to take antibiotics—one was asked to return to the clinic to get their mediation after three days; the other group was given an antibiotic, but told to take the medication only if their symptoms hadn't improved after five to 10 days.

Image: Bigstock

For many conditions, this "alternative" treatment may be just as effective as—and may cause fewer side effects than—pain medication.

If you have chronic pain and are wondering how to avoid the potential side effects associated with long-term use of pain medications, you may want to consider an alternative—acupuncture. Since the technique was introduced in the United States in the 1970s, it has moved from alternative to mainstream medicine. Today, Harvard Medical School and other leading institutions offer courses in acupuncture for physicians, several professional societies certify acupuncturists, and two to three million Americans visit an acupuncturist every year.

Research we're watching

A nationwide survey conducted by researchers at Harvard T.H. Chan School of Public Health indicates that prescription drug use rose from 51% of U.S. adults in the 1999–2000 calendar year to 59% in 2011–2012. In 2012, women were taking more prescription medications than men, with 65% taking at least one drug and 16% taking more than five.

Although the use of postmenopausal hormones declined, women's prescriptions for blood pressure medication, cholesterol-lowering drugs, antidepressants, and diabetes medications rose significantly. The study was published in the Nov. 3, 2015, issue of The Journal of the American Medical Association.

Image: Thinkstock

Tau proteins, and not necessarily beta-amyloid, may be the key to unlocking a viable treatment.

Alzheimer's disease affects more than five million people, and that number is expected to more than double by 2050. While there is no cure, attention has refocused on what many researchers believe is a major player in Alzheimer's: tau proteins.

Image: Bigstock

Ask the doctor

Q. I have difficulty falling asleep, and melatonin has not worked. I want to avoid medications and I have read magnesium supplements can help. Should I try them?

A. Magnesium is an important element in many biological functions, including nerve and muscle function, so it is often proposed as a natural treatment. It has gained some acceptance as a preventive treatment for migraine headaches, but there is not strong scientific evidence for its use with insomnia.

Image: Thinkstock

Targeted cancer therapies have limits, but some may offer a better option than standard chemotherapy.

Mention cancer treatment, and most men think of chemotherapy—complete with hair loss and extreme fatigue. But for some men, there is another option. Targeted therapies can sometimes treat certain cancers with fewer side effects and better outcomes.

Image: Bigstock

Devices to treat nighttime breathing problems may help lower blood pressure and reduce the harm to your heart.

Peaceful slumber is often a pipe dream for people with obstructive sleep apnea. More than 25 million Americans have this problem, in which the tongue or throat tissue temporarily blocks the airway during sleep. The resulting pauses in breathing (called apneas) lead to explosive snoring or gasping for breath—sometimes more than 30 times per hour.

Image: iStock

Cardiologists expect wider use of the less-invasive technique—known as TAVR—in the near future.

The one-way valve inside your aorta opens to allow blood to surge from the heart to the rest of your body. But as you age, the valve's leaflets may stiffen and become clogged with calcium deposits, restricting blood flow. About 12% of people ages 75 or older have this condition, known as aortic stenosis. Symptoms include feeling dizzy, faint, tired, and breathless. Unless the valve is replaced, half of people with symptoms from aortic stenosis die within two years.

Image: Thinkstock

Ask the doctor

Q. I would like to take generic drugs instead of brand-name drugs whenever possible, because they're cheaper. But are they really as effective?

A. First of all, generic drugs contain the exact same active ingredients as the brand-name versions. Second, in the United States, before approving a generic drug, the FDA must test it to be sure that the manufacturer has produced the same molecule, and that it achieves the same levels in the blood as the brand-name drug. Third, there have been many careful studies comparing generic drugs (once they have been approved) to their brand-name equivalents.