Q: I suffered for more than a month with vertigo. My doctor prescribed a seven-day “bubble pack” of a steroid, an antihistamine and meclizine for dizziness. None of it helped much.
Then I found the Epley maneuver. A licensed physical therapist did this simple procedure, and in one session my vertigo was gone! Please tell people about this.
A: Vertigo (a sensation of spinning or whirling) can be caused by several conditions. If the diagnosis is BPPV (benign paroxysmal positional vertigo), then medications won’t help very much. That’s because little calcium crystals (canaliths) have moved out of their normal position within the ear canal. Rolling over in bed or changing head position can be very disorienting.
The Epley maneuver, named for ear surgeon John Epley, involves rotating the head through several positions to reorient the crystals. We encourage people to be evaluated by an otolaryngologist and have a skilled therapist perform the maneuver initially. An article in the journal Neurology (July 24, 2012) reported that YouTube videos can successfully assist patients with BPPV in learning how to manage the procedure at home.
Q: I chewed tobacco for 35 years, starting at age 25 when I quit smoking. My dentist back then, who was a smoker himself, cautioned that since chewing tobacco caused no smoke nor ash and needed no free hand, it could become an all-consuming habit. Did it ever!
I tried several different ways to quit, to no avail. Then in 2013, I tried nicotine gum. A co-worker said he’d quit smoking 20 years ago and still chewed that gum. I tried it too, and it worked for me. My dentist says my gums look as good as anyone’s. And yes, I’m still chewing that gum.
A: We are delighted to learn that you were able to overcome your tobacco habit with nicotine gum. We have heard from many people that this approach is successful, though giving up the nicotine gum can become challenging in itself. This reader came up with a gradual withdrawal process that worked for her:
“I stopped smoking using nicotine gum. After a month on it, I substituted a regular piece of gum for every second piece and then started to cut the nicotine gum in half. It didn’t take me long to break away from it.”
Q: I was prescribed Paxil and Ritalin for anxiety, depression and adult ADHD. Ever since I started taking them, I sweat profusely at night and do not sleep well.
I told my doctor about this at my last visit, and she took me off Ritalin and gave me Strattera. It has been more than a week on the new regimen, but my sweating and insomnia haven’t subsided. Could Paxil be causing these side effects?
A: Paroxetine (Paxil), like similar antidepressants (fluoxetine, sertraline), can cause insomnia and sweating. Consequently, the problem might lie with the Paxil.
Don’t stop it on your own, but do get in touch with your doctor immediately! Paxil can increase blood levels of atomoxetine (Strattera) significantly (Journal of Clinical Pharmacology, November 2002; Clujul Medical, Vol. 88, No. 4, 2015). This could increase the possibility of Strattera side effects such as sweating, sleep problems, fatigue, headache and dry mouth.
For more information on medications and nondrug approaches to depression, we are sending you our Guide to Dealing With Depression. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (68 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. E-7, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
About the Author
