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OCD drugs can affect hormones

My daughter has been suffering from trichotillomania for five years. She has been on a combination of Celexa and Risperdal for several months and has a milky discharge from both breasts. Her gynecologist says Risperdal might be responsible. Is this true?

Trichotillomania is the medical term for hair-pulling, a form of obsessive-compulsive disorder. Antipsychotic medicines such as Risperdal can affect the hormone prolactin and lead to a milky discharge from the breasts. The antidepressant Celexa occasionally has this effect.

Psychiatrists may prescribe antidepressants such as Prozac or Zoloft for this condition. Some have also had success with cognitive-behavior therapy. Look for a therapist with experience in treating trichotillomania.

To learn more, you may want to check the Trichotillomania Learning Center (www.trich.org). It offers references and resources. There is also a good book by experts in the field: Help for Hair Pullers, by Keuthen, Stein and Christenson (New Harbinger, 2001).

Antidepressant side effect

I've heard that premature ejaculation is a common problem. I suffer just the opposite: delayed ejaculation. It can take me 20 or 30 minutes. This has become an issue since I started taking Effexor for depression. I suspect that the drug is responsible, but I don't want to give it up because it works well to improve my mood. Would Viagra or one of the other pills for erectile dysfunction overcome this problem?

Your suspicion is well-founded. Antidepressants like Prozac, Paxil, Zoloft and Effexor can delay orgasm for both men and women. One small study demonstrated that Viagra could reduce ejaculatory delay in some men (Journal of Clinical Psychiatry, June 2003). In general, however, drugs such as Viagra, Levitra or Cialis work for erectile dysfunction but do not improve libido or hasten climax.

Drugs may cause constipation

I have a problem with constipation. My doctor prescribed MiraLax, but it costs $40 a bottle, and I would like a more healthful remedy. When I asked at the health food store, I was told to eat cooked prunes and spinach. I take Calan, Celebrex, Clarinex, Mevacor, Librax and aspirin.

The blood pressure pill verapamil (Calan, Covera-HS, Isoptin and Verelan) is known to cause constipation. Librax, prescribed for digestive difficulties, can also contribute to constipation. So can the pain reliever Celebrex and the cholesterol-lowering drug Mevacor.

With the medications you have on board, it is hardly any wonder that you are having serious difficulties. Perhaps your doctor can find substitutes less likely to cause constipation.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at pharmacymindspring.com or via their Web site: www.peoplespharmacy.org.

King Features Syndicate

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