Archive for February, 2012

Natural recoverers kick addiction without help

Christine Junge

Former Editor, Harvard Health Publishing

We tend to think that stopping an addictive behavior means joining a group, seeing a therapist, going to a treatment center, or taking a medication that helps with cravings. Some people manage to break an addiction without any help. These “natural recoverers” tend to take two key steps: They find a new hobby, challenge, or relationship to help fill the void left by the addiction. And they start exercising. Exercise is important because it acts as a natural antidepressant. It also prompts the body to release its own psychoactive substances—endorphins—that trigger the brain’s reward pathway and promote a feeling of well-being. Natural recovery isn’t a sure thing, and the more severe the addiction, the harder it is to do.

New anti-lice lotion is good news for nitpickers

Former Executive Editor, Harvard Health

The FDA’s approval this week of an old drug called ivermectin for treating head lice comes as good news to folks who shudder at the thought of using a nit comb to remove lice. It will be sold as a lotion under the brand name Sklice. Ivermectin works by interfering with nerve and muscle cells in […]

The 11 most expensive medications

Former Executive Editor, Harvard Health

Some medications can cost as much as $2,000 a year. But according to a post on the Medical Billing and Coding blog, that’s peanuts. The price tag for a year’s worth of Soliris, a drug used to treat a rare blood disease known as paroxysmal nocturnal hemoglobinuria, is $409,500. The blog lists 10 other drugs that cost $200,000 or more a year. All 11 are so-called orphan drugs, developed specifically to treat rare conditions. The post raises questions about how much is too much when it comes to drug costs. If one of these drugs is keeping you or a family member alive, the sky’s the limit. If not, the cost can seem excessive.

Everyday foods are top 10 sources of sodium

Former Executive Editor, Harvard Health

A new report from the Centers for Disease Control and Prevention (CDC) shows that just 10 types of deliver almost half of the average American’s daily sodium. Topping the list are breads and rolls, cold cuts, pizza, poultry, and soups. Almost two-thirds of our daily sodium comes from food bought in stores, and one-quarter comes from food bought in restaurants (which includes fast-food shops and pizza places).The report also showed that Americans take in an average of 3,266 milligrams of sodium a day (about 1½ teaspoons of salt), well above the healthy target of 2,300 milligrams a day. As a nation, cutting back on salt by an average of 400 milligrams a day could prevent 28,000 deaths a year and save $7 billion in health care costs.

Overnight treatment for chronic insomnia

Former Executive Editor, Harvard Health

For some people, trouble falling asleep or staying asleep is just a now-and-then hitch. For others, insomnia is a chronic problem that affects mood, daytime alertness and performance, and emotional and physical health. Some people turn to medications, others to behavioral approaches that often take weeks to get results. A new approach using a 25-hour program called intensive sleep retraining may be enough to break the cycle in a day. Australian researchers showed that it worked better than standard behavioral therapy. As the researchers themselves point out, intensive sleep retraining is expensive. Let’s hope that the Australian study stimulates the creation of similar boot-camp approaches that can be done at home.

Switching to generic Lipitor

Peter Wehrwein

Contributor, Harvard Health

Lipitor, the blockbuster cholesterol-lowering drug, is now being sold as a less-expensive generic. Several other best-selling prescription drugs are set to lose patent protection this year, including Actos, a diabetes drug; Plavix, which helps prevent heart attacks and strokes; and Singulair, an important asthma drug. Although the lower price is great, some people worry that changing from a brand-name drugs to a “no-name” generic one might be risky. Not so, says Dr. Anthony Komaroff, editor in chief of the Harvard Health Letter. In the newsletter’s February 2012 issue, he tackles the brand-versus-generic issue. The FDA is legally required to determine that generic products are “bioequivalent” to brand-name drugs, which means that they produce similar blood concentrations of the same chemical. The vast majority of studies show that generic versions are just as safe and effective as their brand-name counterparts.

Resveratrol—the hype continues

Former Executive Editor, Harvard Health

Resveratrol is a compound found in red wine. A new report published in the journal Cell suggesting that resveratrol blocks the action of a muscle enzyme called phosphodiesterase 4 in mice had headline writers in a tizzy, proclaiming that “Scientists May Be Closer to Developing ‘Red Wine’ Drug” and the like. It didn’t merit that kind of hype. Some research, most of it on cell cultures or laboratory experiments with yeast, roundworms, fruit flies, the short-lived turquoise killifish, or mice, suggest that resveratrol may help fight heart disease, some cancers, and other chronic conditions. But there is little evidence about what it can do for humans, and even less about possible side effects.

FDA needs stronger rules to ensure the safety of dietary supplements

Former Executive Editor, Harvard Health

Back in 1994, the Dietary Supplement Health and Education Act (DSHEA) allowed companies to sell dietary supplements with established ingredients (meaning those that had been sold in the United States before 1994) without any evidence that they are effective or safe. Manufacturers are supposed to give the FDA evidence that a new ingredient should be safe, but this aspect of the law hasn’t been enforced, writes Harvard Medical School’s Dr. Pieter A. Cohen in a commentary in the New England Journal of Medicine. Compare this hands-off approach with the strict rules and regulations for drugs. Last July, the FDA proposed some rules to help it test new dietary supplements. This is a good first step, but the FDA’s plan doesn’t go far enough, argues Dr. Cohen.

Different blood pressure in right and left arms could signal trouble

Former Executive Editor, Harvard Health

Most doctors and nurses measure blood pressure in one arm. A new British study published in The Lancet suggests that measuring it in both arms may be better. A difference in the arm-to-arm readings of 10 points or more can signal circulatory problems that may lead to stroke, peripheral artery disease, or other cardiovascular problems. In older people, an arm-to-arm difference in blood pressure is usually due to a blockage arising from atherosclerosis, the artery-clogging disease process that is at the root of most cardiovascular conditions. Next time you have your blood pressure checked, ask the doctor or nurse to do it on both arms. If there’s a difference greater than 10 point, another test called the ankle-brachial index might be in order to check for peripheral artery disease.