Know a prospective parent worried about having a baby with autism? Lifescript Pharmacist Suzy Cohen weighs in on a newly discovered risk factor for the disease and several other children’s issues, including the best remedies for coughs and whether or not to let teens drink diet soda. And do blood pressure medications work best when taken in the morning or at night? Find out now...
Dear Suzy Cohen,
My husband and I would like to have a child soon. My sister’s little boy has autism, and I’m concerned for my prenatal care and pregnancy. Is there any way to reduce my risk of having a child with autism?
-C.J., Orlando, Fla.
Hi C.J.,
There’s much controversy about potential causes of autism, including vaccinations, but I won’t entertain that idea (which was disproven here). A new study, conducted at Kaiser Permanente’s Northern California Research Division in Oakland, found mothers of autistic children were twice as likely to have taken an antidepressant in the year prior to their delivery. The risk appears even stronger if the antidepressant is taken during the first trimester.
The 2011 study, published in the Archives of General Psychiatry, analyzed prenatal data for women who took selective serotonin reuptake inhibitor (SSRI) antidepressants. These are commonly prescribed mood enhancers known generically as paroxetine, sertraline, citalopram, escitalopram and fluoxetine.
This begs the question: Should you wean off antidepressants if you are planning to become pregnant?
It’s certainly worth a discussion with your doctor, along with other treatment options for depression, both pharmaceutical and alternative. Knowing your choices becomes incredibly important, since there’s no cure for autism. Anything you can do to prevent it is helpful.
My concerns aren’t about the medication; it’s that some physicians prescribe these drugs at the drop of a hat to women who have underlying hormonal or micronutrient deficiencies. If you’re planning to become pregnant and wish to discontinue your antidepressants, talk to your doctor about tapering and eventually stopping your dosage. Don’t stop taking an SSRI on your own – do it with medical supervision and approval.
Also be aware that this study is being reported inaccurately by many publications, who are saying autism rates increased in children whose mothers took SSRIs during the year before they got pregnant. The study says problems happened to women who took the medication just before and during their pregnancy. Big difference.
For information on autism, check out these resources: www.autismspeaks.org and www.defeatautismnow.net
To submit your own question to Suzy Cohen, visit www.DearPharmacist.com.
Dear Suzy Cohen,
My teenage daughter drinks several diet sodas a day. She insists they’re a healthy alternative to regular sodas and will help her lose weight. Should I be concerned?
-E.L., Phoenix, Ariz.
Hi E.L.,
YES, you should be concerned.
Several studies found diet soda isn’t healthy. Last year, doctors at the International Stroke Conference in Los Angeles reported that people who drink diet soda every day have a 61% increased risk for a “cardiovascular event.” However, the research hardly made the news.
Another study of 3,000 nurses found that drinking just two diet sodas a day was linked to decreased kidney function. Kidneys filter your body of poisonous toxins. You really want your kidneys in tip-top shape to keep yourself “clean,” which is why I recommend drinking plenty of fresh, filtered water.
Does diet soda help with weight loss? A Diabetes Care study found that people who drink at least one diet soda a day experienced a 36% increased risk for developing metabolic syndrome, a disorder that includes the triple threat of high blood pressure, cholesterol and glucose. Metabolic syndrome almost always includes obesity. If you connect the dots, it doesn’t appear that weight loss is a benefit of drinking diet soda.
If you love soda (diet or regular), make it a special treat rather than your beverage of choice all day long. Or create your own natural soda: Combine carbonated (seltzer) water with grape juice (or root-beer-flavored stevia drops), and – voila! – you have a natural fizzy drink! You should also include healthy teas as part of your diet, like Tulsi, Rooibos and green tea.
Why not try juicing? Blend 3 carrots, 2 celery stalks, a slice of ginger, 2 apples and take a swig. It’s good-tasting and good for you!
(Learn more about the science behind diet soda in Are Diet Sodas Harming Your Health?)
Dear Suzy Cohen,
I take four different medications for blood pressure in the morning. The labels all say, “Take once daily.” Is that the best way to take them? I bought a blood pressure monitor and test myself. My blood pressure is great all day but rises by nightfall.
–D.F., Hollywood, Fla.
Hi D.F.,
Timing medications is very important, because your body has its own biological clock. At night, melatonin seeps out of your brain to help you fall asleep. The body’s production of growth hormones, antioxidants and neurotransmitters is also ramped up at night. In the morning, your body clock releases cortisol and other “stress” hormones which gently raise blood pressure as you wake up.
I think it’s sensible to take some of your blood pressure meds in the morning and some in the evening. I base my recommendation on research that found some people experience a rise in blood pressure while sleeping, rather than a dip.
In healthy people, blood pressure naturally dips about 10%-20% while sleeping. You want to be a dipper because it reduces the overall risk of cardiovascular complications. But, as I said, some people don’t dip at night; this phenomenon affects at least 10% of hypertensive patients, but the risk is greater if you have kidney failure to go with that hypertension.
Most people with high blood pressure take multiple meds. There are hundreds available. Among the most common are diuretics (which should always be taken in the morning), ACE inhibitors, beta blockers, calcium channel blockers or ARBs (angiotensin receptor blockers). Now, if you take all of your blood pressure pills in the morning, the effects may wear off at about the same time (in the evening). This leaves you more susceptible to higher pressure while you sleep.
Taking one or two of your blood pressure medications at bedtime might help you experience that dip, which is especially crucial if you’re at high risk for heart attack or stroke. Italian researchers evaluated some people with hypertension and kidney disease. They asked participants to switch one of their drugs from a morning dose to a bedtime dose.
In about 60 days, almost all of them [90%] experienced an average drop in blood pressure of 7 points, without experiencing any more side effects or spikes in their daytime blood pressure. Not only that, but kidney function improved significantly too!
A common side effect with blood pressure drugs is orthostatic hypotension, so be sure to get up very slowly from a sitting or resting position to avoid feeling faint or dizzy. Timing won’t alter your risk for this particular side effect. First, ask your physician or local pharmacist if spreading your medications apart is right for you.
Dear Suzy Cohen,
My 5-year-old daughter has developed a persistent cough. Can you recommend something to help?
-L.E., Seattle, Wash.
Hi L.E.,
You should see your pediatrician to find out what’s causing that cough. Likely triggers include pet dander, pollen, mildew spores, perfumes or scented products, and even chemicals used in crafts.
A friend of mine had a persistent childhood cough that developed every winter. She kept telling her parents it felt like she had hair in her throat. As was common practice back then, her pediatrician recommended a tonsillectomy.
My friend had her tonsils removed, and it didn’t make a bit of difference. She kept on coughing every winter. As an adult, a light bulb went off inside her head. That cough really was from hair, or rather fur! Her mother used to cover her with a squirrel coat, and she’d bury her face in its folds. If her parents had only listened to her about the “hair,” she might have been spared the surgeon’s scalpel.
Back to your story: I don’t suggest over-the-counter cough remedies for your child, although cough drops are OK. Medical researchers have shown that most of the time they don’t work well on children, and they can have some serious side effects. A 2007 study tracked groups of children with upper respiratory tract infections who received the cough suppressant dextromethorphan, a spoonful of honey or no treatment at all before going to bed.
Researchers had parents report on both coughing and whether the child got a good night’s sleep. Guess which remedy won the day? A teaspoon of honey! Here’s what the researchers said: “Parents rated honey most favorably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection.”
You should never give honey to children under the age of two, as some studies report it may trigger allergic reactions and it has been associated with various toxins. However, you should also never give cough suppressant medication to young children, unless recommended by a pediatrician, because it can slow breathing.
Want to know more? Get your own copy of The 24-Hour Pharmacist and Drug Muggers: How To Keep Your Medicine From Stealing the Life Out of You! Plus, meet Dr. Suzy Cohen.
Are You Diet Soda Savvy?
Most people assume it's what they're eating that packs on the pounds. But it might be what's at the other end of your straw, not fork, that's really to blame. And don't think you're exempt just because you drink all things diet.
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