Medications Archive

In the journals

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Low-dose aspirin therapy has been shown to help prevent heart attacks, but a study in the Aug. 4, 2018 issue of The Lancet suggests men who weigh more than 154 pounds may need higher doses. Researchers analyzed 10 trials that evaluated daily aspirin therapy for cardiovascular disease prevention in 120,000 men and women. The study participants had no history of heart or vascular disease. The researchers found that low-dose daily aspirin — 75 to 100 mg — was associated with reduced risk for heart attack and stroke among both men and women who weighed less than 154 pounds.

However, there was no significant effect for heavier patients. (About 80% of the men in the study were among this group.) The reason? The researchers speculated that people with more weight also have higher amounts of esterase, an enzyme that reduces how much aspirin is available in the body.

Ketamine offers a new option for people with stubborn depression that doesn't respond to other medications.

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Many people know of ketamine as a hallucinogenic and addictive street drug, which, when abused, can put people in medical peril. But today, doctors are increasingly looking to ketamine as a potentially lifesaving treatment for people with severe, treatment-resistant depression, who may be at high risk for suicide.

"Ketamine has been shown to be effective in people who have not responded to antidepressant treatment," says Dr. Cristina Cusin, an assistant professor of psychiatry at Harvard Medical School. The fast-acting treatment has shown promise — sometimes improving depressive symptoms within hours of the first intravenous treatment.

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Urgent care clinics are convenient when you don't feel well and can't see your doctor right away. But a study published online July 16, 2018, by JAMA Internal Medicine found that people who go to such clinics may be more likely to be given prescriptions for unnecessary antibiotics. Researchers analyzed 156 million insurance claims from 2014 and found that 46% of people treated at urgent care centers for viral conditions — like a bad cold, the flu, or viral bronchitis — were prescribed antibiotics. The problem: antibiotics kill only bacteria, not viruses. The study underscores the need to ask health care workers if you have a viral or a bacterial condition before you take antibiotics.

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If you've tried to buy medications by phone or on the Internet but received an FDA warning letter instead, beware. The FDA warns that criminals are forging these notes, possibly with the goal of later getting your money. The letters look official, like they're from the FDA or the Federal Trade Commission, and they claim that the FDA has identified drug violations based on a review of your parcel and social media accounts. Don't be fooled. The FDA doesn't send letters to consumers. So why are you getting one? The FDA says it may be because you're contacting an illegal online pharmacy. "Many of these illegal websites appear legitimate, and it can be hard to tell the difference," notes FDA Commissioner Scott Gottlieb. They may try to sell your personal information or charge you for products you never ordered. And scams aren't the only risks. Illegal pharmacies typically sell counterfeit — and unsafe — medicines. If you believe you've received a fake warning letter, email the FDA at FDAInternetPharmacyTaskForce-CDER@fda.hhs.gov. Send information about the letter or a scan or photo of the document.

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We're learning more about the link between weight gain and several major classes of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), like sertraline (Zoloft), and tricyclic antidepressants, such as amitriptyline (Elavil). Research has shown that putting on pounds is a possible short-term side effect of the medications. But a study published May 23, 2018, in The BMJ suggests that antidepressants are also associated with sustained weight gain. Researchers analyzed the health information of more than 300,000 people in the United Kingdom (average age 51) who'd had their weight and body mass index measured at doctor appointments between 2004 and 2014. About 18% had been prescribed antidepressants. During the study period, people who took antidepressants had a 21% higher risk for a 5% or greater weight gain, compared with people who didn't take antidepressants. The risk peaked in the second and third years. There was no evidence of weight gain after seven years. The study was observational and didn't prove that antidepressants cause weight gain. But researchers hope the findings will encourage people to talk to their doctors about weight gain as a possible side effect of antidepressants, and plan for potential and even delayed weight gain if they're using the medications.

Research we're watching

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Do you take generic drugs to lower your blood pressure or cholesterol? You may save money by paying out of pocket at Walmart instead of a paying a Medicare prescription copay, according to an analysis in the July 24 Annals of Internal Medicine.

Walmart (and a number of other large chain stores) offer generic drug discount plans; they sell 30-day supplies of popular generic drugs for $4.

New medications add advantages to treatments that help prevent stroke, pulmonary embolism, and deep-vein thrombosis.

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The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa).

Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). A dose of vitamin K is used to reverse the action of warfarin (Coumadin), a blood thinner used routinely for more than half a century and, until recently, the only such option for most people.

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Are you taking a medication that has depression or suicidal thinking as a potential side effect? One or both risks have been linked to use of more than 200 prescription and over-the-counter pills, including medicines that treat high blood pressure, heartburn, pain, and headaches. The more of these drugs you use, the higher the likelihood that you'll experience depression, suggests a study published June 12, 2018, in The Journal of the American Medical Association. Working with five surveys conducted over a nine-year period, researchers evaluated health information from 26,192 adults. About 37% of them reported taking such medications. Of individuals taking three or more of the medications with depression as a possible side effect, about 15% reported depression, compared with about 5% in people not using those medications. Even for people already taking an antidepressant, the addition of one or more of the identified medicines was linked to higher rates of depression. This study was based on surveys, so it didn't prove that the medications caused the reported depression. Nonetheless, if you think you're depressed (and have symptoms such as apathy, hopelessness, changes in sleep or eating habits, and persistent fatigue), ask your doctor if any of the medicines you are taking may be responsible.

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These strategies keep you healthy and safe through your 60s, 70, and 80s.

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After age 60, men tend to get thrown together — the so-called 60-and-older group — even though most are quite different in terms of their health.

"While many men are still very fit well into their 60s, 70s, and 80s, others face health challenges and chronic diseases that make daily living difficult," says Dr. Howard LeWine, assistant professor of medicine at Harvard Medical School.

In the journals

Many people with rheumatoid arthritis (RA) also deal with ongoing depression and anxiety related to their pain and disability. While drugs used to treat the disease help alleviate the joint pain and stiffness, a recent study suggests they may not extend to improving patients' mental health.

The findings, published online June 6, 2018, by Arthritis & Rheumatology, reviewed more than 70 clinical trials and found only a small association between various drugs used for RA, such as adalimumab (Humira), rituximab (Rituxan), abatacept (Orencia), and tocilizumab (Actemra), and mental health outcomes in patients.