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A popular alternative to a traditional sleeping pill

In the last few years, the prescribing rate for zolpidem, a popular sleeping pill, has been declining in favor of the "off-label" use of an antidepressant called trazodone, which is known for its ability to make people drowsy. But doctors are concerned that trazodone hasn't been well studied for insomnia, it is not FDA-approved to treat the condition, and there are sparse data showing that it is safe or that it works for patients with insomnia. Experts advise choosing medications based on a patient's specific needs, not a trend.

A major change for restless legs treatment

In its 2025 guidelines for treating restless legs syndrome (RLS), the American Academy of Sleep Medicine stopped recommending the long-term use of dopamine agonist drugs, since they can eventually make RLS symptoms worse. Instead, the guidelines strongly recommend another class of medications as the first-line treatment: alpha-2-delta ligands, such as gabapentin (Neurontin), gabapentin enacarbil (Horizant), and pregabalin (Lyrica). Alpha-2-delta ligands do not make RLS symptoms worse.

When the doctor needs a new heart valve

About one in every 20 people over age 65 has a stiff, narrowed aortic valve. A Harvard physician describes his experience with this condition, called aortic stenosis, from the heart murmur detected at age 66 to his open-heart surgery a decade later. After his diagnosis, he received echocardiograms every one to two years to check the valve, and later a stress echocardiogram. Because the echocardiogram revealed an aortic aneurysm, he had open-heart surgery so the surgeon could repair the valve and the aneurysm during the same operation.

Is your heart ready for sex?

Most men can resume regular sexual activity after a heart attack once they can engage in mild-to-moderate physical activity without experiencing marked fatigue, chest pain, or shortness of breath. For heart-related procedures like angioplasty with stent placement (to open a blocked artery and restore blood flow), coronary artery bypass surgery, or open-heart surgery, men should wait until surgical sites have fully healed before resuming sex. At the same time, men should address any lingering heart disease risk factors, such as high blood pressure and excess weight.

Heat wave hazards

Certain medications can leave people more vulnerable to heat-related effects or the sun's rays. The medications can raise the risk of dehydration, make people sweat too much or too little, impair the body's ability to regulate temperature, or raise the risk of getting a bad sunburn. In addition, higher temperatures may damage some medicines, including diuretics, blood pressure drugs, some antidepressants, thyroid replacement hormones, and some over-the-counter antihistamines.

How is metastatic prostate cancer detected and treated in men over 70?

The US Preventive Services Task Force recommends against screening for prostate cancer in men older than 70, but as life expectancy for this group increases and treatment options evolve, it's important for men to be aware of their options.

Do you really need bunion surgery?

Surgery is usually warranted when bunion pain becomes disabling, a skin ulcer develops, or it's necessary to prevent a bunion from dislocating the second toe. However, recovery can be long and painful, and there's no guarantee that bunions won't come back. Prior to surgery, it might help to use strategies that reduce bunion pain, such as adding cushioning to shoes, stretching shoes where a bunion rubs against them, getting roomier shoes or shoes made with stretchy fabrics, and using toe spacers.

Diabetes drugs may improve risks for some conditions, but worsen others

A 2025 analysis suggested that GLP-1 medications used for diabetes and weight loss are associated with lower risks for an array of conditions, but that they increase risks for several others.

Research highlights health benefits from cold-water immersions

While there are limited studies about the health benefits of cold-water immersions, a 2025 analysis found regular ice baths or cold showers may help reduce stress levels, improve sleep, and increase quality of life.

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