It is a fact of life that modern medicine, despite its many faults, has brought us some genuinely useful remedies for problems that are difficult to treat through natural means. It is for you and your doctor to decide what is best for you; we mention conventional drug therapies simply because they do provide substantial relief in many cases where alternatives are unavailable.
Since the 1960s, L-dopa (a critical ingredient used by the brain to produce the chemical dopamine) has been one of the main therapies used in the treatment of Parkinson's disease. Several different versions of L-dopa have been developed over time, providing advantages over previous forms.
Conventional medical treatment still relies heavily on L-dopa (levo-dihydroxy-phenylalanine), a dopamine precursor that can cross the blood-brain barrier and is converted to dopamine in the brain. L-dopa is now rarely used by itself, but rather in combination with carbidopa (Sinemet) or benserazide (Madopar) that protects it from breaking down before it reaches the brain tissue. As L-dopa must compete with other amino acids in crossing both from the gut to the blood stream and from the blood stream to the brain, it is usually recommended that it be taken between meals rather than with meals.
Although L-dopa medications can bring significant relief from Parkinson's disease symptoms they become less effective with time. After four or five years of increasing dosages their effect becomes sporadic and unpredictable (the "on-off syndrome") and patients become increasingly helpless and depressed. There is also evidence that the use of L-dopa medications may lead to a deficiency of B-vitamins, especially niacin and vitamin B-6. Most Parkinson's disease experts now recommend that L-dopa therapy be started as late as possible after diagnosis of Parkinson's disease so as to postpone the day when it no longer works and to limit its many serious adverse effects.
Selegiline (Deprenyl, Eldepryl) is another drug used in Parkinson's disease therapy. It works by blocking the breakdown of dopamine in the brain. Trials have shown that starting Parkinson's disease patients on selegiline can extend the time period before they need L-dopa by about nine months. Combinations of L-dopa medications and selegiline have also been tried in early stage Parkinson's disease patients, but were found to have no advantage. A more recent study concluded that the combination therapy increased mortality by about 50% when compared to Parkinson's disease patients treated with L-dopa medications alone.
Anticholinergic drugs work by reducing the amount of acetylcholine produced in the brain and thereby redressing the imbalance between dopamine and acetylcholine. They are no longer recommended for older patients as they have serious neuropsychiatric side-effects.
Antihistamines may cause drowsiness. Alpha-adrenergic topical sprays reduce congestion but there is a rebound effect if used for more than a few days. Cromolyn sodium is the only preventative drug choice; works as well as antihistamines but does not cause drowsiness; take continuously or it will not work effectively; it is virtually without side-effects.
Nonsedating antihistamines may cause life-threatening irregular heartbeat and should not be taken with other drugs or if you have other liver or heart problems. Oral decongestants may have systemic side-effects. Nasal corticosteroid sprays are effective if used properly; improvement takes 1 to 2 weeks. Systemic steroids are prescribed only for severe allergic rhinitis; generally prescribed for short amounts of time because of their many side-effects.
NOTE: Extended use of antihistamines or nasal sprays can make your allergic rhinitis worse.
Commonly recommended drugs include prednisone and cyclophosphamide.
Conventional medicine can control myasthenia gravis. Some medications improve neuromuscular transmission and increase muscle strength, and some suppress the production of abnormal antibodies. These medications must be used with careful medical supervision because they may cause major side effects.
Corticosteroids such as prednisone and/or other anti-inflammatory medications can be prescribed to reduce inflammation. Other medications, particularly those that suppress the immune system, are often recommended. Lung involvement may benefit from inhalers; each symptom can usually be relieved by treating with appropriate medications.
If simple measures don't alleviate the problem, you may need conventional medication. Although a wide range of drugs (including phenylpropanolamine, ephedrine and the nonsteroidal antiinflammatory drugs indomethacin and ibuprofen) have been used to treat hypotension, many of them are not consistently effective.
The following medications have proven effective in treating postural hypotension:
Fludrocortisone. Fludrocortisone is a mineralocorticosteroid that appears to be effective for most types of postural hypotension. It works by promoting sodium retention by the kidney, thereby causing fluid retention and some swelling, which is necessary to improve blood pressure. Its sparing effect on sodium is done at the expense of a concurrent loss of potassium. Therefore, when taking fludrocortisone, it's important to also take adequate amounts of potassium each day. Fludrocortisone has none of the anti-inflammatory properties of cortisone or prednisone and it is not a muscle-building agent.
Midodrine. Midodrine activates receptors on the arterioles and veins to produce an increase in blood pressure. Studies show that it is effective in improving standing blood pressure in those with postural hypotension related to nervous system dysfunction, such as in patients with Shy-Drager syndrome.
People with severe cases take medicine to slow their digestion.
A Japanese drug, phenoxazine carboxylic acid (Catalin), has been shown to be effective in inhibiting, as well as reversing, cataract formation.
If intercourse is painful, you can apply xylocaine jelly to numb the sore areas.
Although resistance is increasing, most types of malaria can still be cured with prescription drugs. The type of drugs and length of treatment depend on which kind of malaria is diagnosed, where the patient was infected, the age of the patient, and how severely ill the patient was at start of treatment.
Recommended treatment is a seven-day course of oral quinine plus clindamycin under the careful supervision of a physician. Fatigue, malaise and a low grade fever may persist for weeks or months after treatment has been completed.
In the early 1990s, doctors noted that many depressed men refused to take their medications because it prevented them from reaching a climax, so they prescribed antidepressants, such as Anafranil, Paxil, Prozac or Zoloft to premature ejaculators, who then reported better performance. A recent study from the Netherlands shows that 20mg of Paxil 1-4 hours before the event may be the most effective treatment. [Journal of Clinical Psychopharmacology, 2001, Vol 21, Iss 3, pp293-297.] The U.S. FDA has not approved these drugs for this purpose.
People with this condition generally require life-long treatment with lithium or other drugs to control manic episodes, sometimes with antidepressants to control the depression. Some doctors believe that a significant bipolar disorder will not respond sufficiently to alternative interventions alone.
The most effective medications for OCD are the SSRIs (Selective Serotonin Reuptake Inhibitors) Prozac, Paxil, Luvox, and Zoloft as well as the tricyclic Anafranil. Other medications may be added to improve the effect.
Medications that may reduce symptoms of labyrinthitis include antihistamines, anticholinergics, sedative/hypnotics, antinausea medications and diazepam (valium). The antihistamine meclizine (Antivert) is commonly used.
Subcutaneously injected sumatriptan (6mg in 0.5ml) (Imitrex in the US) is the most effective, reliable, and rapid abortive therapy for cluster headache attacks. An injection (easily given by the patient) eliminates or markedly diminishes cluster headaches within 15 minutes in essentially all patients at every attack. Some patients have had headaches eliminated in as little as 7 minutes. This effect does not lessen with continued use. Some patients have had satisfactorily rapid results with sumatriptan nasal spray. The oral triptans are less effective, but some especially good responders with relatively milder and slower-developing headaches may prefer this route of administration.
There is no single, accepted gold standard treatment for idiopathic cyclic edema. Several different treatments have been reported. An agent used for treating high blood pressure called Captopril has also been used with success. It works against the kidney hormone aldosterone which is elevated in this condition and causes excess salt and water retention.
Sometimes a mild diuretic will help reduce fluid retention but can worsen the edema of idiopathic cyclic edema. While one would think that taking a "water pill" or diuretic would improve this edematous condition, it turns out that in most cases this is the wrong long term treatment. In fact, chronic diuretic use will increase the secretion of aldosterone which in turn produces more edema. If the chronic use of diuretics is discontinued, the cyclical swelling disappears in most cases within about 3 weeks.
The prescription drug Hydergine stimulates regrowth of damaged nerve fibers. The most effective form of Hydergine comes in tablets, which can be placed under the tongue for immediate absorption. Ask your doctor about Hydergine if you feel you need help in this area.
Since the 1800s, colchicine has been the standard treatment for acute gout. While colchicine is very effective, it often causes nausea, vomiting and diarrhea. These side-effects are uncommon when this drug is given intravenously, but because of their unpleasant nature, non-steroidal anti-inflammatory drugs (NSAIDs) have become the treatment of choice for most acute attacks of gout.
Therapy directed at normalizing uric acid levels in the blood should be considered for patients who have had multiple gout attacks or have developed tophi or kidney stones. Several drugs that help the kidneys eliminate uric acid are available, such as probenecid, and a drug that blocks production of uric acid by the body, such as allopurinol. The choice between these two types of drugs depends on the amount of uric acid in the urine. With correct treatment, gout should be well controlled in almost all cases.
Corticosteroids do not always help a lot and in such cases immunosuppressive medications are considered. These medicines can be effective by suppressing the immune response which attracts the white blood cells of inflammation to the muscles. Many types are now commonly used and others are still experimental.
Methotrexate can be taken by mouth (Rheumatrex) or by injection into the body; Azathioprine (Imuran) is an oral drug. Both can cause liver and bone marrow side-effects and require regular blood monitoring. Cyclophosphamide (Cytoxan), chlorambucil (Leukeran) and cyclosporin (Sandimmune) have been used for serious complications of severe disease. These also can have severe side-effects which must be considered with each patient individually.
Patients with calcium deposits (calcinosis) from dermatomyositis can sometimes benefit by taking diltiazem (Cardizem) to shrink the size of the calcium deposits. This effect, however, occurs slowly – frequently over years.
Doctors may feel they have to resort to drugs like Sinequin (Doxepin) or Klonopin (Klonazepam). Sinequin is a tricyclic anti-depressant and anti-histamine that can produce marked sedation. This medication may enhance the effect of Klonopin, but it can reduce muscle twitching all by itself. Klonopin is an anti-anxiety medication and anti-convulsive/anti-spasmodic. It is useful in dealing with muscle twitching, restless leg syndrome, and night-time grinding of the teeth (bruxism).
If you do decide to use conventional medications that may help relieve the compression, such as prednisone and antivirals, they should be started as quickly as possible. The "window of opportunity" for starting these medications is thought to be 7 days from the onset of Bell's palsy.
Treatment depends on the underlying disorder which has caused nephrotic syndrome. Medications which dampen down the immune system are a mainstay of treatment. The first choice is usually a steroid drug such as prednisone. Some conditions may require even more potent medications, such as cyclophosphamide or cyclosporine.
Treating the underlying conditions (for example lymphoma, cancers, heroine use, infections) which have led to nephrotic syndrome will often improve the symptoms of nephrotic syndrome as well. Some patients will require the use of specific medications to control high blood pressure. Some patients benefit from the use of diuretics (which allow the kidney to produce more urine) to decrease swelling.
Nephrotic syndrome may require aggressive treatment with corticosteroids until the level of proteinuria goes down. A person usually needs to lose more than 3gm per day of protein in the urine before this begins to happen.
Acute IgAN may be treated with oral steroids.
Impaired kidneys are very good at secreting a hormone which deliberately raises blood pressure. It is imperative that any treatment for controlling high blood pressure be followed rigorously, as high blood pressure itself further adds to the damage being caused in the kidneys, and it is an independent risk factor for ESRD (not to mention other cardiovascular complications). In addition to lowering blood pressure, some specific high BP medications appear to have renal-protective and/or antiproteinuric effects.
Simeprevir (approved in 2013 and sold under the names Olysio, Sovriad, Galexos) is a medication used in combination with others to treat hepatitis C genotype 1 and 4 with cure rates of 80-90%. Unfortunately, at the time of writing (late 2017), the cost was a prohibitive $150,000 for a 12-week course. Danoprevir in 2017 was a clinical candidate based on its favorable potency profile against multiple HCV genotypes 1-6 and key mutants. Both of these drugs were developed by exploiting earlier (abandoned) research on Ciluprevir.
Previously, Reuters had reported on Oct 27, 2003 that scientists working for Boehringer Ingelheim in Germany developed a drug that could offer new hope. Ciluprevir, originally developed under the research code of BILN 2061, targets an enzyme to block the replication of the virus. In eight people given four doses of the treatment, the amount of virus in the blood (viral load) dropped by 100 to 1,000-fold after 48 hours without producing any unpleasant reactions. BILN 2061 was the first of a class of drugs called NS3 protease inhibitors to be tested in humans.
Unfortunately, although BILN 2061 demonstrated potent antiviral activity against HCV genotype 1, the virologic response was less pronounced and more variable in HCV genotype 2 and 3 patients. Despite early enthusiasm, further development was halted due to concerns related to potential cardiotoxicity in animal models.
Glyburide and Metformin are oral diabetes medicines that help control blood sugar levels in some people with Type 2 Diabetes, generally in conjunction with proper diet, exercise, and/or other medications.
In the late 1990s, Dr. David Bell, a clinician and researcher in Birmingham, Alabama, wanted to see if he could eliminate insulin use in a group of people with Type 2 Diabetes who were already on insulin by using a combination of oral medications. These people had in many cases been put on insulin without first trying oral medications because today's array of medications were not available when they were diagnosed.
Dr. Bell first tested C-peptide levels and chose only those who had normal levels. Of the 130 people with adequate C-peptide levels in his study, 100 were able to discontinue insulin use altogether and control their diabetes on various doses of glyburide and metformin. He found that their overall control, measured by their HbA1c levels, was actually better on two oral medications than it had been previously on two daily doses of insulin. Others in the study were able to improve their hemoglobin levels by using glyburide and metformin with a single dose of insulin at dinner or bedtime.
Researchers have determined that the Type 2 patients most likely to control their blood sugars on combination oral agents are those least overweight (with a BMI of 30 or less), with shortest duration of diabetes, and C-peptide levels normal or only slightly low.
For prevention of stone formation, medical therapy is available for those with known predisposing conditions. For those with stones, pain-killers (as prescribed by a doctor) can provide great relief. In addition, some medications may help break down larger stones.
Pin-X (pinworm treatment containing pyrantel pamoate) is available over-the-counter as a single dose remedy. If you have side-effects after taking pyrantel, get advice from your health care provider before you take it again, especially if a skin rash occurs.
Although the directions do state "single dose effectiveness", taking a second dose after 10 days is also recommended because of the pinworm lifecycle. After the initial treatment, pinworm eggs will almost certainly remain in your living environment and may be ingested or inhaled.
Mebendazole is the standard treatment.
Mebendazole is the drug of choice, with albendazole as an alternative.
Pneumonia caused by bacteria and mycoplasma is generally treated with antibiotics. The type of antibiotic used depends on which organism has caused the infection. If the infection is severe, and especially in very young and old people, the pneumonia may need to be treated in hospital with antibiotics and fluids given into a vein, and extra oxygen through a mask.
Fungal pneumonias are treated with specific antifungal drugs.
Nizoral is the only shampoo containing a patented active ingredient known as ketoconazole. This ingredient is proven to be effective against P. ovale and acts directly to inhibit growth of the fungus. This product is the number one choice of doctors and pharmacists, when recommending an anti-dandruff shampoo. The effects of Nizoral can last several days, making daily use unnecessary.
For many patients with hives of unknown cause, treatment with antihistamines is effective. This is because in people with hives, histamine is being released by mast cells in the tissues which in turn initiates the irritation and accumulations of fluid. Other inflammatory white blood cells, including lymphocytes and polymorphonuclear cells, have also been implicated. Antihistamines inhibit this inflammatory process.
On occasion and especially with pressure hives, antihistamines are ineffective, probably because of the nature of the molecular mediators operating in this condition. If antihistamines do not help, then several second-line treatments are used. The most effective are corticosteroids. Others include doxepin, dapsone, attenuated androgens, calcium antagonists, antimalarials, gold and methotrexate.
Ritalin or other stimulant drugs have been used successfully in controlling the need to sleep during the day.