Antidepressant Can Be a Remedy for Essential Tremor
Question: I have something called essential tremor: My hands shake. It is embarrassing to have friends and family members notice this shakiness when I pass a drink or hold my fork.
When I read in your column that the drug Remeron could control this condition, I was elated. I told my doctor, but he said he couldn’t locate any research on this and wouldn’t prescribe it. He said the condition doesn’t need to be treated.
I hate trembling, especially when I thread a needle or put on eyeliner. Please tell me more about this medicine.
Answer: Remeron (mirtazapine) is actually an antidepressant, but it has been helpful for some patients with tremor.
Drs. Virginia Pact and Thomas Giduz published their preliminary findings in the journal Neurology (Sept. 22, 1999). The doctors first suspected that Remeron would be helpful when they collaborated in treating a 73-year-old woman who had Parkinson’s disease and was depressed. She had been an avid bridge player, but the Parkinson’s disease made her hands shake so much she had trouble holding her cards. When her depression was treated with Remeron, the tremor vanished.
Remeron is taken at bedtime. Possible side effects include drowsiness, dizziness, dry mouth, constipation, increased cholesterol levels and weight gain. Anyone who develops a sore throat, fever or mouth ulcers while on Remeron should get immediate medical attention.
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Q: I’ve been using Afrin for three weeks because of a cold that just wouldn’t go away. Now I am having a hard time stopping the nasal spray. I can’t breathe through my nose when the Afrin wears off. How can I get off Afrin?
A: Gradual tapering may be the answer. One reader suggested diluting the Afrin with a saline solution (Ayr Saline, NaSal or Ocean) every time the bottle was half-empty. Within several weeks the concentration of Afrin was so low that he had no trouble stopping.
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Q: I would like to know more about how to use Tagamet to get rid of warts. I keep getting small warts on my fingers, about the size of a match head. I have had them taken off by the dermatologist, but they keep popping back up. I’d appreciate any information you can give me.
A: It is hard to understand how the ulcer drug Tagamet (cimetidine) could banish hard-to-treat warts, but a report in the Archives of Dermatology (June 1996) noted that more than 80% of patients treated with this drug had a significant response. Not all studies have produced such impressive results, however. Some researchers speculate that Tagamet modifies the immune system so it can reject the wart virus. It takes about two months to detect improvement, so patience is necessary. Because the dose that doctors have used is high (30 mg/kg/day), you should discuss this treatment with a physician before undertaking it. Tagamet can interact with many other medications, so double-check with your pharmacist before starting such therapy.
Alternatives
Q: I am 42 and have suffered from psoriasis for 30 years. With age, the skin lesions got worse; I had five or six on my chest and back that were at least 3 inches across. My elbows and knees were covered with red, rough plaques and silver scales.
For years I have used Ultravate ointment two or three times a year. After applying it twice a day for two weeks, most of the plaques would turn pink with no scale, but my elbows, knees and one spot on my back didn’t change at all. Within a month all the spots would be as bad as ever.
Last spring I developed a taste for hot, spicy food. I started eating salsa almost every day, and graduated from mild to medium to hot.
During this time, the ointment worked amazingly well. The psoriasis plaques disappeared after the pink stage. I can’t remember the last time that happened. Then, with no treatment, my elbows and knees started to clear. Now I have only one lesion bigger than a dime.
At first I didn’t make a connection between the hot peppers and the lesions clearing, but then I read that capsaicin from hot peppers is used as a topical treatment for arthritis and psoriasis.
As a test, I stopped eating hot peppers, and within two weeks the remaining lesions became inflamed and irritated. Selfishly, I ended the test immediately. Sure enough, the plaques got much better when I started eating salsa again. Have you heard from anyone else with a similar reaction?
A: We found a number of studies supporting the value of topical capsaicin (the hot compound in chili peppers) in treating psoriasis. It depletes substance P, a chemical involved in inflammation and pain.
As far as we can tell, no one else has tested oral capsaicin as you have. Not everyone likes hot peppers as much as you do, but we would love to hear from anyone else trying your remedy.
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Q: It is very difficult to find information regarding interactions of drugs, herbs and vitamins. Do ginkgo biloba and garlic interfere with blood clotting? My husband is on Coumadin, and I take aspirin daily. Also, does glucosamine interfere with insulin? My husband is a diabetic.
A: Both ginkgo biloba and garlic might slow blood clotting and could interact dangerously with Coumadin or possibly with aspirin to increase the risk of bleeding.
Glucosamine is popular for relieving arthritis pain. Although it is not a carbohydrate, there are some reports of higher blood sugar in people taking glucosamine. If your husband tries this supplement, he should monitor his blood sugar closely.
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Q: My mother’s remedy for gas cramps was caraway tea. Just steep some caraway seeds in hot water. Caraway always helps with gas buildup, which is why we Germans add it to sauerkraut.
A: We’ve heard fennel tea is good for gas. Since caraway is related, we are not surprised it might help.
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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Send questions to People’s Pharmacy, King Features Syndicate, 235 E. 45th St., New York, NY 10017, or e-mail pharmacy@mindspring.com.
