Drugs and Supplements

Follow the poodle? Alternatives to prescription sleep medications

Stuart Quan, MD
Stuart Quan, MD, Contributing Editor

If you’ve been having trouble sleeping, you may be concerned that there’s no other option besides prescription sleep aids. Fortunately, there are many other treatments to pick from. In fact, sleep specialists now agree that behavioral (non-drug) treatments should be the first treatment for most cases of insomnia. But beware: not all non-drug insomnia treatments are created equal.

Why are doctors writing opioid prescriptions — even after an overdose?

Joji Suzuki, MD

A recent study of nearly 3,000 patients who had an overdose during long-term opioid treatment found that more than 90% of these patients continued to receive opioids — even after their overdose. Poor communication between emergency rooms and prescribing doctors is likely the culprit. What’s more, doctors receive little training in recognizing patients at high risk for overdose, or in treating addiction when they do spot it. An important strategy to address the current opioid crisis is to improve how doctors are educated about opioids.

Cold and flu warning: The dangers of too much acetaminophen

Susan Farrell, MD
Susan Farrell, MD, Contributing Editor

Many common cold and flu medications and prescription-strength pain relievers contain acetaminophen (Tylenol) as one of their active ingredients. If you take several of these drugs at once during a bout of cold or flu, you might accidentally take more than the safe dose of acetaminophen, potentially causing liver damage. It’s always best to read the labels — and to keep in mind that most winter viruses get better on their own with rest, fluids, and time.

Taking new aim at cancer

Matthew Solan
Matthew Solan, Executive Editor, Harvard Men's Health Watch

Last year, only months after announcing that he had an aggressive form of melanoma, former President Carter declared that he was cancer free — thanks at least in part to a recently approved immunotherapy drug. Immunotherapy is a type of targeted therapy that helps boost the body’s own immune response to cancer. It does so while sparing healthy cells, thus minimizing side effects.

Teens and medicines that cause birth defects: Do doctors drop the ball?

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publications

Doctors may prescribe medicines for teenage girls — for example for acne, depression, or migraines — that are known to cause birth defects. While most parents and doctors hope that these young women avoid pregnancy for many reasons, adults need to help adolescent girls understand the risks of the medications they take and have frank conversations about sex and birth control.

New cures for hepatitis C — but are they affordable?

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

Recently, several new drugs have been developed to treat hepatitis C, a serious viral infection that can cause severe liver damage if allowed to run unchecked. But these new drugs are incredibly expensive, and are unaffordable for many people who need them. Until drugs for hepatitis C (and other high-cost drugs) are priced at affordable levels, many people will be left unable to benefit from modern advances in drug therapy.

Reversing the effects of the new anti-clotting drugs

Samuel Z. Goldhaber, MD
Samuel Z. Goldhaber, MD, Contibuting Editor

Anticoagulants — drugs that reduce the blood’s ability to clot — are used to treat clots in the lungs and legs and to prevent strokes in people with the heart rhythm abnormality called atrial fibrillation. The anticoagulant warfarin has been used for these purposes for many years. But it is difficult and time-consuming to find the optimal warfarin dose, and it carries a risk of difficult-to-control bleeding. Newer anticoagulants offer an easier and equally effective way to control the blood’s clotting ability, but until recently, there was no way to reverse the effects of these drugs if necessary. The approval of new antidotes to these newer anticoagulants will enable doctors to prescribe these drugs with increased confidence.

Do statins interfere with the flu vaccine?

John Ross, MD, FIDSA
John Ross, MD, FIDSA, Contributing Editor

The statin drugs are very effective at reducing LDL (“bad”) cholesterol and may also reduce inflammation throughout the body. Both of these properties can reduce the risk of cardiovascular problems. At the same time, research — some of it conflicting — suggests that statins may also affect the body’s immune system. In particular, they may dampen the response to vaccines.

The very high cost of very low cholesterol

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

The FDA recently approved two new drugs that quickly and effectively lower LDL cholesterol levels. This exciting development is tempered by the very high cost of these drugs. These costs can even trickle down to others on the same insurance plan as people taking these new drugs. Several politicians and institutions have spoken out against these high costs, but it is unlikely that the prices will be lowered anytime soon. For now, these drugs should be reserved only for those whose other efforts to reduce LDL have been unsuccessful.

The placebo effect: Amazing and real

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Many people believe that the placebo effect is solely a psychological phenomenon. But for some people, a placebo can have real, measurable therapeutic benefits. The power of the placebo effect is significant enough that it can actually skew study results. Additional research is needed to better understand how to leverage the placebo effect and when doing so might offer real benefits to patients.