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In addition to counseling, behavioral conditioning, coaching, and support groups, four drugs—brand names Adderall, Dexedrine, Ritalin, and Concerta—are commonly used to treat ADD in adults and children.

The meds affect the activity of two key brain chemicals, dopamine and norepinephrine, and this can affect individuals in different ways. (That’s why Adderall might help one ADD sufferer, while Ritalin works best for another.)

For people without ADD, these medications work as stimulants, increasing activity and speeding up response time. But they have the opposite effect on people with ADD or ADHD. Instead of being hyperstimulated, a person with ADD will feel calmer, more focused, and less impulsive—hence, she may get more done in less time, but she won’t feel jittery or “speedy.”

A newer, nonstimulant drug, called Strattera, is another option. It may be a better choice for women who also suffer from anxiety, have a history of substance abuse, or have experienced insomnia or weight loss with amphetamine meds, says Tracy Latz, MD, a psychiatrist and associate clinical professor at Wake Forest University Medical Center. Its downside? Strattera must be taken for two weeks to have effect, while amphetamines often bring instant relief.

 
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by Curt Pesmen
The third of 5 operations you don’t want to get—and what to do instead.

Every year in the United States, surgeons perform 1.2 million angioplasties, during which a cardiologist uses tiny balloons and implanted wire cages (stents) to unclog arteries. This Roto-Rooter-type approach is less invasive and has a shorter recovery period than bypass, which is open-heart surgery. The problem: A groundbreaking study of more than 2,000 heart patients, just released this year at a cardiology conference and in The New England Journal of Medicine, indicated that a completely nonsurgical method—heart medication—was just as beneficial as angioplasty and stents in keeping arteries open in many patients. The bottom line: Angioplasty did not appear to prevent heart attacks or save lives among nonemergency heart subjects in the study.

What to do instead
Take the right meds. If the study is right, medications may be as strong as steel. “If you have chest pain and are stable, you can take medicines that do the job of angioplasty,” says William Boden, MD, of the University of Buffalo School of Medicine, Buffalo, New York, and an author of the study. Medicines used in the study included aspirin, and blood pressure and cholesterol drugs—and they were taken along with exercise and diet changes.

“If those don’t work, then you can have angioplasty,” Boden says. “Now we can unequivocally say that.”

Of course, what’s right for you depends on the severity of your atherosclerosis risks (blood pressure, cholesterol, triglycerides) along with any heart-related pain. The onus is also on the patient to treat a doc’s lifestyle recommendations—diet and exercise guidelines—just as seriously as if they were prescription medicines.

There is no one-size-fits-all treatment for hypothyroidism. It may take a few trips to the doctor to get the right remedy, and over time, your prescribed medication may change. Here’s a brief look at the possibilities:

Synthetic hormones.
Most people with hypothyroidism first receive a synthetic thyroid hormone known as levothyroxine; the brand names are Synthroid, Levoxyl, Unithroid, and Levothroid. This medication often gets you back to normal within weeks. And you’ll take it for the rest of your life. But it doesn’t work for everyone.

“About 80 percent of patients who test positive for hypothyroidism get a prescription for levothyroxine and feel better,” says endocrinologist Theodore Friedman, MD, PhD, an associate professor of medicine at Charles R. Drew University of Medicine and Science and the University of California, Los Angeles. “For the other 20 percent, we need to be flexible. I get the patients who tell me conventional treatment isn’t working. And I believe them.”

Combination therapy.
Your thyroid produces two hormones, but synthetic levothyroxine replaces only one, known as T4. The biochemistry can get complicated, but basically your body has to convert T4 into yet another hormone called T3 for your thyroid to work well.

Experts like Friedman and Baylor University’s Ridha Arem, MD, a nationally known endocrinologist, believe T4 treatment alone doesn’t do the job for some patients. For them, Friedman also prescribes a small amount of supplemental T3 (brand name Cytomel), so-called combination therapy.

Other animal-based hormones.
Some experts may even reject this approach in favor of animal-based hormone treatment (the most common brand is Armour). Manufactured in the United States for more than 100 years, this medication is made from the desiccated thyroid tissue of pigs.

The major thyroid organizations consider it outdated, but some specialists swear by it. “I clearly have patients who do better on Armour,” Friedman says. Even its strongest advocates aren’t sure why Armour would be more effective. But it contains both T3 and T4, as well as lesser-known hormones called T1 and T2 and other substances.

By Melanie Haiken

From Health Magazine

Karen Mullin had always been able to eat what she wanted with no worries of packing on pounds—until she began battling “middle age spread” last year at age 44. Despite eating right and exercising, the scale wouldn’t budge. Frustrated, Mullin took Ritalin, a drug used to treat attention def-icit hyperactivity disorder, “borrowing” it from a friend. One of its side effects is weight loss, making it a popular diet drug for everyone from soccer moms to starlets. “You hear about how some drugs like Ritalin can just melt the pounds off,” she says, “so you figure why not?”

Should you try it?
Mullin tried the drug only once on a lark without a doctor’s guidance (not recommended). But more docs, frustrated with the handful of U.S. Food and Drug Administration (FDA)–approved weight-loss drugs with inconsistent results, are prescribing medications that are used to treat everything from depression to seizures—all with the side effect of weight loss—to help patients drop pounds.

For doctors, this off-label prescribing is legal. In fact, a study that appeared recently in the Archives of Internal Medicine suggests that 21 percent of prescriptions for 160 common drugs (some 150 million prescriptions) are being written to treat conditions for which they aren’t specifically approved. But some experts believe it can set both patients and their doctors up for big letdowns.

Is this a big risk?