Question: My son's teacher says he can't sit still and pay attention. She wants him to take Ritalin. My wife doesn't believe in drugs. I am caught in the middle. What are the pros and cons of Ritalin?
Answer: Although teachers can spot behavior problems in the classroom, your son needs to be evaluated by an experienced therapist. For some children with attention deficit disorder, Ritalin (methylphenidate) can be helpful. It also may cause stomach aches, reduce appetite and slow growth. Kids sometimes have trouble sleeping, but taking the pill early in the day usually prevents this complication.
A child who needs medication and doesn't get it may also suffer negative consequences. Poor performance in school and difficulty with peers can lead to a downward spiral in self-esteem and more serious behavior problems.
Ritalin is neither good nor evil. It is merely a tool to be used in conjunction with special teaching approaches and parental support.
Impotence has many causes
Question: I am 20, and I think I have a problem with impotence. Please tell me what causes impotence and if there is anything that can be done about it. Can nervousness contribute? What about anti-depressants like Zoloft? I would like to have kids someday and hope this difficulty won't prevent that.
Answer: Impotence has many possible causes. Some, such as nerve damage or difficulties with blood flow to the penis, are more common in older men. One exception may be damage to nerves caused by an accident or by excessive bicycle riding.
Psychological factors, including "performance anxiety," can definitely have an impact. Worrying about getting an erection can prevent one.
Anti-depressants such as Prozac and Zoloft can sometimes interfere with sexuality.
You should see a urologist who is experienced in diagnosing and treating sexual dysfunction. Whether the problem is physical, psychological or pharmaceutical, there are many successful treatments available.
We are sending you our Guide to Drugs That Affect Sexuality and Treatments for Impotence so you will have an overview of your options. Anyone else who would like a copy may send $2 with a long (No. 10) stamped, self-addressed envelope to Graedons' People's Pharmacy, No.YP-120, P.O. Box 52027, Durham, NC 27717-2027.
Drug alone may not work
Question: I read about ReVia helping alcoholics overcome their addiction. I would like to know how much this medicine would cost. It sounds as though it might help my son, who is addicted to alcohol and drugs. I want to help him get better.
Answer: ReVia (naltrexone) has been shown to reduce cravings for alcohol and narcotic drugs. It is not, however, a magic bullet.
Alcoholics must be motivated to change before ReVia can help. A treatment program should be comprehensive and include counseling and support.
This medication can be quite expensive. A two-month supply could cost more than $250. But compared to the long-term toll of alcoholism and drug addiction, ReVia may be worth the price.
Two medicines that clash
Question: I recently flunked a bone density test. I've been told I have osteoporosis. I am on Axid for reflux, and the doctor said he didn't want that to get any worse.
He prescribed Miacalcin nasal spray, but I wonder if Fosamax would be a better choice.
Answer: Because of your digestive problems, Fosamax may not be appropriate. Some people have experienced serious heartburn and esophageal irritation from Fosamax.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. They can be reached by e-mail at PHARMACYmindspring.com or in care of the Times, P.O. Box 1121, St. Petersburg, FL 33731.