long term sudafed use
Your Good Health: Continuous Use of Pseudoephedrine Not RecommendedFebruary 3, 2016 04:20 AM Dear Dr. Roach: My girlfriend has been taking Pseudoephedrine HCL for at least one year. Take an average of four 30 mg pills a day. As far as I know, he started this to keep his breasts open and help his nasal breathing. I am concerned about addiction and long-term effects. He was in Adderall once, and he claims that pseudoephedrine helps his approach. She's been previously diagnosed with depression, and takes Cymbalta and trazodone. Does that make sense? Would you see that an ENT specialist would be beneficial? A.S. The first question is whether pseudoephedrine (Sudafed and others) is a safe and effective treatment for chronic nasal congestion. Although pseudoephedrine has some efficacy in chronic congestion, it also has some potential for abuse, and I would be more concerned about its side effects, including sleeping difficulty, irritability and tremor, and headache. It can raise blood pressure, especially in people who already have a certain degree of elevation. It is not recommended for chronic use. The second problem is if your girlfriend has a condition like ADHD, and if so, if pseudoephedrine is a useful treatment. The first part of that, I cannot answer, except to say that it is likely that some prescriptor thought so, as she was treated with amphetamines. I can say that pseudoephedrine is unlikely to have any significant benefit in adult ADHD. I think it would benefit from seeing a healthcare provider, both to find the correct diagnosis and treatment for your nasal complaints, and to determine whether you have ADHD or other condition that requires treatment. Most general doctors have experience in chronic nasal problems, but a psychologist or psychiatrist is usually necessary to make the diagnosis and prescribe treatment for ADHD. Dear Dr. Roach: I am a 62-year-old man who had chickenpox as a child and received the herpes vaccine more than a year ago. A week ago, I had a pain in my left shoulder that I periodically put and attribute to the tension or sleep on my shoulder in an uncomfortable position. The day after the pain began, a pain also developed in my armpit. The next day, an eruption developed on the front of my left shoulder, and then under my arm, and then finally on the back of my shoulder. Online research suggests herpes and indicated that the vaccine is only 51% effective. I went to a treatment clinic. Based on symptoms and appearance, the doctor confirmed that they were herpes. I got valaciclovir and meloxicam. After 48 hours, shoulder pain and armpit has not decreased. The rash seems to be drying, but now it's starting to bite. How long should I expect the symptoms to remain? Does the fact that the vaccine did not prevent herpes leave me prone to future outbreaks? Are symptoms developed over time? I.B. This sounds like a herpes, a re-emergence of the chickenpox virus you've had since childhood. Although the herpes vaccine did not prevent the infection, it significantly reduces the likelihood of developing long-term pain (called post-herptical neuropathy) as a result of herpes. The vaccine does not increase your chance of developing herpes for the second time, which is rare. Most 60-year-olds with herpes have symptoms that gradually improve over a week to a few weeks. Dear Dr. Roach: I was diagnosed with emphysema 12 years ago, and I have been in oxygen for 10 years and in Flovent, a corticosteroid inhaler, for the last five years. I'm 86. I just had a long bone density test and they told me that I have border osteopenia, a precursor of complete blood osteoporosis. The two previous tests, performed at three-year intervals, showed "younger" bone density than my age group. I am quite active: I raise a garden, live by myself and cook my own healthy meals. My weight is on the light side. I am concerned about the continued use of corticosteroids, as it is a potential path to osteoporosis in my old age! Any ideas or advice? Please don't say, "If it's not broken, don't fix it," because that's what worries me! A.G. Osteopenia is not a disease, and it does not need to be treated. It is a warning that bones are losing mineralization, which increases the risk of fracture. At 86, that is extremely common, especially in slightly constructed women and those with a history of smoking, which inferi of emphysema (although there are less common causes of emphysema). Inhaled corticosteroids like Flovent increase the risk of bone loss; however, you have to balance the risks and benefits. In most people with emphysema, there is a modest benefit and a small risk. I feel like it's probably worth it, but you can discuss it with your doctor. Trend Stories Dr. Roach regrets that he cannot answer individual letters, but he will incorporate them into the column whenever possible. Readers can send questions to . Read Related TopicsLatest Health Popular health News & ToolsOthersConnect
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