Attention-deficit drugs may raise blood pressure

Q: I have been diagnosed with ADD. My doctor prescribed Adderall to try and improve my ability to focus.

I don't find that it helps much, and I worry that I might be at risk for heart problems. I do have high blood pressure. Are there safer medications I could ask my doctor about?

A: Stimulant medications such as amphetamine (Adderall) and methylphenidate (Concerta, Metadate, Ritalin) may raise blood pressure and increase the risk of heart attack, stroke or sudden death.

Since you already have hypertension, taking amphetamine could counteract the effectiveness of your blood-pressure drugs. You may want to ask your physician about nonstimulant alternatives that won't affect your heart.

Low-dose estrogen ring

Q: You had a question from a woman suffering vaginal dryness. I am using Estring, an estradiol ring. After 18 months, I have experienced no side effects, and my dryness is gone.

A: Estring is a prescription vaginal ring that releases 2 mg of estradiol over three months. It is convenient, and the dose of estrogen is quite low.

Spicy stuff

Q: The lady who was concerned about her husband's hot food causing an ulcer should ease up. My stomach used to bother me until I started using jalapeņo peppers, salsa and Tabasco sauce on scrambled eggs, hash browns and pinto beans. I have no more stomach problems.

A: Despite its reputation, spicy food does not necessarily cause ulcers. Animal research suggests that the essence of chili peppers (capsaicin) may even help protect the stomach from aspirin damage.

Q: I am a yoga teacher with a generally mobile body. During the past couple of years, I have suffered worsening muscle pain, cramping and restricted movement.

When a recent flulike episode caused me stomach distress, I gave up my two cups of Earl Grey and switched to orange pekoe tea. Within two weeks, all symptoms were gone and mobility was restored.

I am still drinking tea and have made no other conscious changes, so it seems that the Earl Grey tea is somehow the cause of my problems. What is there in Earl Grey that could set up this reaction?

A: A doctor in Austria published a report on a man who developed muscle cramps in his feet and legs after he started drinking a lot of Earl Grey tea (The Lancet, April 27, 2002). When the patient stopped the Earl Grey tea, his symptoms also disappeared.

Earl Grey tea is flavored with bergamot oil, from the citrus fruit bergamot. It contains a compound called bergapten that can block potassium channels. Potassium flow in and out of the cells is crucial for muscle function, and this presumably explains why too much Earl Grey tea could cause muscle cramps.

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