Wellbutrin | Bupropion | Antidepressant

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[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Originally marketed by its brand name Wellbutrin, most people receive the far less expensive generic bupropion.  The drug remains one of the most frequently prescribed anti-depressants capitalizing on the widespread perception it causes fewer side effects.  Arguably less weight gain and fatigue occur with bupropion than with other anti-depressants.  Additionally it may alleviate some of the sexual dysfunction associated with members of the SSRI family such as Prozac, Zoloft and Celexa. While physicians tend to champion one anti-depressant over another, statistics fail to reveal substantial difference between drugs commonly utilized to combat the disorder.  Due to individual sensitivity, some people may respond more favorably to one drug or experience fewer side effects compared to other options.  Interestingly for the majority of people,…
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Nuplazid Adverse Reactions

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Potentially severe adverse reactions including death warrant reconsideration of Nuplazid.  The drug continues to be heavily promoted to the public on television commercials and to the profession in journal advertisements.  Unfortunately Nuplazid offers few benefits compared to the major risk of complications.  Marketed as a breakthrough therapy to combat the hallucinations and delusions associated with Parkinson’s Disease, it barely surpassed the merits of an inactive placebo.  Except the placebo was neither associated with death nor did it cost anywhere near the staggering $30,000 a year commanded by Nuplazid.   During Nuplazid’s short time on the market, the Food and Drug Association Adverse Events Reporting System or FARES received more than 5700 reports of problems associated with the drug.  This included more than 1800 serious reactions and 712 deaths.  Although FARES…
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Trulicity | Expensive Diabetes Treatment

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Trulicity represents an expensive add-on treatment to assist in controlling type 2 diabetes.  Only one shot of Trulicity every 7 days is standard in addition to routine diabetes therapy.  The cost for one month of Trulicity for a cash paying patient averages about $800. A battle is brewing between Trulicity and a closely related competitor - Victoza.  Both activate the GLP-1 receptor which leads to greater insulin release and decrease in a hormone, glucagon, that counteracts the action of insulin.  In the process emptying of the stomach is slowed which results in reduced appetite and then the possibility of weight loss. Side effects tend to be mild but relatively common.  Among the most frequent are nausea in up to 20%, vomiting in 10%, diarrhea in 10% and abdominal pain in…
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SeroVital | A Growth Hormone Booster?

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  The question is whether SeroVital really boost growth hormone and if so does it matter?  Containing a smaller amount of amino acids than in a bite of steak, chicken or salmon, this supposed human growth hormone booster makes preposterous appearing claims based on extraordinarily shaky evidence. While using such enticing catch-phrases as anti-aging, breakthrough and fountain of youth, the packaging promotes SeroVital to increase lean muscle mass, reduce wrinkles and more. A $100 investment buys one month of product but at best the “increase” in growth hormone raises it only into the low normal range. Ingredients include small amounts of lysine, arginine and several other trace compounds in amounts dwarfed by those in the American diet.  While marketing hype suggests special benefits for these supplements, it seems difficult to…
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Oxycodone Dangerous Narcotics

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[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Oxycodone and its extended release version Oxycontin belong to the narcotic family of opioids. Closely related compounds include codeine and hydrocodone. Extreme care must be exercised in prescribing oxycodone in combination with muscle relaxants, sleeping pills, anxiety medications and other pain relievers. Surprisingly even the antibiotics erythromycin and clarithromycin or the stomach acid reducer Tagamet generically available as cimetidine may increase the risk of unexpected overdose and death from respiratory arrest. Adding oxycodone/oxycontin to illicit street foretells disaster. Oxycodone was originally synthesized in 1916 in Germany.  An interesting historical note, Adolf Hitler was apparently addicted to it among other substances by his personal physician.  Most prescriptions for these drugs fail to meet current guidelines for correct use.  Treatment for low back pain,…
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Cialis | Expensive Erectile Dysfunction Treatment

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Erectile Dysfunction or simply ED at least temporarily affects more than 40% of men beyond age 40. The popular family of inhibitors of an enzyme known as PDE5 include Cialis, Viagra and Levitra.  All of these drugs work basically in a similar manner.  Selection of which to choose relate more to personal preference and cost than other factors.  These drugs require sexual stimulation and release of nitric oxide from the tissues in order to function.  Cialis neither functions as an aphrodisiac nor as a treatment for premature ejaculation.. The typical dose of Cialis is 10 mg no more frequently than daily.   Results appear within 30-45 minutes when combined with sexual stimulation.  Due to its slow metabolism, a considerable amount remains in the tissues for more than 17 hours.  Lasting longer…
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Claritin | Buy Generic Loratadine Instead

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Whether Claritin now available as the generic loratadine actually works at the currently approved dose remains an issue. Originally an FDA examiner believed no less than 40 mg was necessary to provide effective relief of allergic nasal symptoms. Unfortunately at this dose drowsiness occurs and the label could no longer boast of non-sedating qualities. At the current daily dose of 10mg, the drug works somewhat better than a placebo. For most people troubled by seasonal or perennial allergies, Flonase, Rhinocort or Nasonex remain more effective. A barrage of direct-to-consumer advertising introduced Claritin to the marketplace.  Claritin along with a competitor Allegra almost overnight became synonymous with anti-histamines and anti-allergy medication.  At first requiring a prescription, these costly drugs siphoned exorbitant financial resources away from more critical areas of need.  Finally…
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Trintellix | Costly Therapy

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Trintellix is a costly therapy for depression that basically offers the same anti-depressant activity as the generic forms of Prozac, Zoloft, Paxil or Celexa but at a much greater price.  Nowhere in the barrage of televised advertising is there mention that the daily cost of the drug exceeds $10 versus $3-10 for one month of the generic versions of similarly acting selective serotonin reuptake inhibitors. How well this drug works for depression remains the subject of controversy.  Most people enrolled in trials suffered from moderate rather than severe depression.  While study outcomes appeared statistically significant, the practical real world benefit may not be clinically relevant. An estimated 5-10% of patients in a family doctor's office may suffer from symptoms of depression with the number rising to as many as 15%…
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Amlodipine | Norvasc | Calcium Blocker

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Amlodipine or Norvasc is a calcium blocker that treats high blood pressure. This inexpensive, generically available drug relaxes smooth muscle cells lining arteries and reduces the force against which the heart must pump. Additionally the drug helps protect against chest pain or angina. It ranks among the World Health Organization List of Essential Medicines. An estimated 14 million people take this drug either by itself or combined with other antihypertensive therapy.  The most consistent benefit of treating high blood pressure involves lowering the risk of stroke adn to a lesser extent heart disease.  Obviously Amlodipine only treats rather than cures elevated blood pressure. Those at greatest risk receive the most benefit.  This translates to a greater reduction in risk among those with also have diabetes and elevated cholesterol. Traditionally diuretics…
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Hydrocodone | Usually Unnecessary

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Hydrocodone and its relative oxycodone result in more than 2 deaths every hour - daytime and nighttime - throughout the year. Sadly more than 90% of the world’s hydrocodone is consumed in the United States, yet it regularly fails to perform up to expectations. Governmental authorities who once championed prescriptions for chronic back pain, arthritis and fibromyalgia.  They now realize the monster they created. Current recommendations suggest severe restrictions on this compound. First synthesized in the early 1920s in Germany the drug languished until approval in the United States in 1943.  Problems with addiction and dependence were noticed in the early 1960s.  In spite of this, various state medical authorities mandated treating pain be considered a priority.   It was considered inappropriate for a doctor not to simply assume a patient's…
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