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Don't stop anxiety medication on your own
DEAR DRS. DONOHUE AND ROACH: About two years ago, I had an anxiety attack. The doctor prescribed Xanax, and I was on it for a short time. He then switched me to respiridone, 0.25 mg. I am trying to go off respiridone also. Is it better to fight a nervous episode or to take a pill? I have good days and not-so-good days. I have gone as many as eight days without taking a pill, then the nervousness comes back. Will I ever be able to get over these anxiety attacks? -- B.G.
ANSWER: Panic attacks are very common, and it seems increasingly common in the stressful world we live in. I don't always treat panic attacks with medication, but for people with recurrent panic attacks or with high levels of constant anxiety, then treatment is of benefit. Treatment can be with or without medications.
While Xanax and its cousins are useful in the short term, most physicians don't often use them for the long term.
Medications like Prozac or Zoloft are most commonly used in people with long-term anxiety and panic. However, many people get outstanding results from psychotherapy with a psychiatrist or therapist. A combination of medication and psychotherapy may be most effective, and medication often can be slowly tapered off.
I wouldn't try to taper yourself off the medicine anymore until you get further help.
READERS: The booklet on herpes and genital warts explains these two common, distressing infections in detail. Readers can obtain a copy by writing: Dr. Donohue -- No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
DEAR DRS. DONOHUE AND ROACH: My fingernails are like tissue paper. What do you recommend? -- B.L.
ANSWER: I have seen remarkable results from using silica gel as a supplement. I rarely recommend supplements, and always try to make my answers based on data, but I can't find a study that confirms what my clinical experience has told me. Silica gel can be very effective at making nails stronger.
Thin nails are most commonly caused by iron deficiency anemia, but can be caused by other, less-common conditions such as Plummer-Vinson syndrome, which usually has mouth pain and difficulty swallowing associated. Hyperthyroidism doesn't cause thin nails, but can cause the nails to split off of the nail bed and become brittle.
These are only some examples of actual diseases that affect nails, so a visit with a dermatologist might not be a bad idea if my suggestion doesn't work.
DEAR DRS. DONOHUE AND ROACH: What is the story with Boniva and jaw problems? I had an abscessed tooth, which was partially treated, and the dentist said it had to come out. I was last treated with Boniva in 2010. Do I need to worry? -- G.W.
ANSWER: The concern when taking medications like Boniva (which also includes Fosamax and Actonel, used mostly for treatment of osteoporosis but can be used for people with cancer and elevated calcium levels) is that there is a complication called osteonecrosis of the jaw. This condition, though rare, is painful and difficult to treat. However, the vast majority of people who developed it did so after intravenous, not oral, treatment with these medicines, and usually for cancer, not osteoporosis. The likelihood of developing osteonecrosis of the jaw while on one of these medicines is much smaller than 1 percent.
Certainly, you should not let the concern prevent you from getting needed dental care.
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Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers also may order health newsletters from www.rbmamall.com.
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