Adderall can affect sex drive

Q: I am 39, my husband is 42, and we are having some trouble. My husband takes Adderall for ADD and has zero sex drive. He says he has felt this way for many years, due to the medication. We've tried Viagra and Cialis. They help his erectile dysfunction but do nothing for his libido. How can we improve his desire for sex? I am feeling frustrated and hurt.

A: Adderall (mixed amphetamines) is used to treat a sleeping disorder called narcolepsy as well as attention-deficit disorder (ADD). Initially, amphetamines may increase sex drive, but over time interest in sex may diminish. Impotence is also a potential side effect. Animal studies suggest that amphetamines can suppress testosterone production and may account for these complications.

Drugs like Viagra, Levitra and Cialis don't affect libido, so we're not surprised they did not improve his desire. Unless he can find a different way to deal with his ADD, it may be difficult to solve this problem. An endocrinologist can test to see if his testosterone levels are low. If so, hormonal replacement may help.

Q: My doctor has me on Plavix to improve circulation in my legs. Television ads always include the statement "Plavix, taken in conjunction with aspirin," etc. Should I be taking aspirin as well?

A: You should take aspirin only if your doctor prescribes it. Plavix and aspirin can interact to cause dangerous bleeding.

Q: Does internal cleansing (colon hydrotherapy) work? Does it improve health? Is there really many years' worth of fecal matter impacted in my colon?

A: According to the doctors who specialize in gastrointestinal problems, the idea of fecal matter accumulating in the colon for years is an urban legend. No studies demonstrate that colon cleansing results in better health.

Q: Why do doctors put patients on sleeping pills for years? A friend has taken Ativan for a long time and is now addicted to it. She is not the same person she once was. Is there any hope for her?

A: Sleeping pills can seem like a simple solution for insomnia, but drugs like Ativan (lorazepam), Dalmane (flurazepam), Halcion (triazolam), ProSom (estazolam), Valium (diazepam) or Xanax (alprazolam) may lead to dependence. Sudden discontinuation can cause rebound sleeping problems as well as other symptoms (agitation, anxiety or tremor). Short-acting drugs like lorazepam or triazolam may be especially problematic.

Gradually withdrawing over weeks or months may work. Some doctors prescribe longer-acting sleeping pills to ease this process.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org