Coming off Anti-Depressants Safely

First, anti-depressant medications can be extremely helpful for some patients. When they are helpful, they should be used at least for 9-12 months. Second, some herbals can be as effective as the drugs with fewer potential side effects. I like to use SAMe and PeanRich. Others like St. John’s Wort, but it too can have side effects. Patients want to come off the drugs because they no longer need them, the side effects are bothersome, the cost is high, or they were never were that effective. Third, if you come off anti-depressants, do so slowly and under a doctor’s supervision. We often use a supplement called Empower plus to to help the transition. We also find it extremely helpful to measure the urine neurotransmitters so we can boost up the ones that are low. This can be an effective way for patients to get the benefits without the drugs.

See Holistic Primary Care, Fall, 2010, p. 7.

Sinusitis Often Does not Respond Well to Antibiotics

Sinus cleansing might be a better approach than antibiotics for persistent sinusitis and even for upper respiratory infections, according to an article in Holistic Primary Care. Sinus irrigation with salt water, usually with one version or another of the Neti Pot, clears out mucous and makes it easier for the body to conquer the infection. Homeopathics can also help by stimulating the immune system. We have been using the cold laser with excellent results. Keep in mind that chronic sinus infections are mostly due to fungus and need to be treated with anti-fungals, probiotics and a low-carbohydrate diet.

See Holistic Primary Care, Fall 2010, P. 8.

Medicine is Simple: Lifestyle Works far Better than Drugs or Surgery

Colin Kopes-Kerr, MD, wrote a powerful editorial in American Family Physician stating that it is clearly time for change. For centuries, medical practice has responded to disease with drugs, remedies, surgery and a pittance of lifestyle counseling. He lists 10 major studies that demonstrate the higher value of primary prevention, which consists of a healthy diet (5-7 servings of fresh fruits and veggies a day), no obesity, regular exercise (150 minutes a week), no smoking, and reduced stress (15-20 minutes of pure relaxation a day). The impact on disease prevention, longevity and quality of life is huge, twice as much as everything else that is taught in medical schools. It is not that hard to do, for most of us. Get busy, America, and stay well.

See www.aafp.org/afp(click here) American Family Physician, Vol 82, No. 6, Sept. 15, 2010:610-14.

The Right to Bear Arms is Uniquely American

Lawrence Gostin, JD, of Georgetown University Law Center wrote an editorial blasting the US judicial system for its interpretation of the second amendment. “Why is the right to bear arms fundamental, when it appears that firearms—designed to cause injury or death—are antithetical to social order and public safety?” In 2007, the US had 78,622 nonfatal injuries and 31,224 deaths due to firearms. The firearm death rate for our children less than 15 years old is 12 times higher than the combined rates in 25 comparable countries. A homeowners gun kills many times more friends and family members than intruders, and too frequently it does not remain in the home or in possession of the owner.

See JAMA, October 6, 2010—vol 304, No. 13: 1485-6.

Forget Mouth-to-Mouth CPR!

Physicians from around the country participated in a 5-year study to evaluate CPR taught to the general population and medical personnel. They concluded that patients had increased survival with compression-only CPR. Only 30% of patients needing CPR get it. Avoiding the mouth-to mouth guideline increased the percentage of patients receiving CPR. For those who did get either kind of CPR, survival of patients was in the 10-20% range, but it was better when compression was not mixed with breathing for the patient, if intubation was not available. The best action is to compress vigorously at 100 times per minute until the patient can be shocked by a portable defibrillator.

See JAMA, October 6, 2010—Vol 304, No. 13, 1447-1455.

Inadequate Dose of Glucosamine Does not Help Back Pain

A Norwegian study published in the AMA Journal supported the pharmaceutical industry by claiming that glucosamine does not work for arthritis in the low back. They were able to do so by using only half the effective dose of 3 Gm per day and omitting cofactors, especially MSM and certain herbals like boswellia. I find that the liquid glucosamine/MSM combo preparation works better than the pills for most patients. Glucosamine does not work for everyone, but neither does Motrin, Celebrex, or Alieve, which cause way more side effects in the stomach, kidneys, and heart.

See JAMA 2010;304(1):45-52.

You Don’t Have to Use CPAP for Sleep Apnea

Sleep apnea is frequently missed, partly because it is not thought of and also because patients cannot imagine sleeping with a machine. Some people do quite well with CPAP, but others do not. Several new oral appliances can be worn at night with an 80% success rate if the baseline apnea-hypoxia index is less than 30 events per hour. If the appliances do not work, surgery can be considered, including the newer procedures that alter the positioning of the jawbone. Finally and probably primarily is effective weight loss. The greater the weight loss, the better the result. We have some good techniques to insure weight loss nowadays. So that might be the best answer for you.

See Family Practice News (click here), July issue, p. 74.