Anti-smoking drug tied to outbursts

Q: Last night, my boyfriend became so violent, I was afraid he was going to hit my 22-year-old daughter or me. He threatened to burn down our home, and he tried to kick me out.

I realized that he started changing after he began taking Chantix to quit smoking.

I read on your Web site about possible violence and aggression from a combination of Chantix and alcohol. There needs to be a warning about this drug.

A: Some people taking Chantix have become violent. We have heard from others that alcohol may aggravate aggression linked to Chantix.

Even without alcohol, this stop-smoking drug may trigger extreme emotions. One woman wrote: "I took Chantix exactly as prescribed, and within two days, I was a changed person: irritable, with wild mood changes, yelling and screaming at everyone. I would even become violent with close family when things didn't go my way."

Q: You wrote recently about Voltaren Gel for sore joints and said it is a prescription product. I bought a tube over the counter when I was in New Zealand a few years ago.

A: Countries have different regulations regarding which drugs require prescriptions and which are available over the counter (OTC). Topical diclofenac (Voltaren) requires a prescription in the U.S., but not in New Zealand. This gel is used to ease the pain in joints, tendons, muscles and ligaments due to arthritis, bursitis, sprains and strains.

Q: I am concerned about all the drugs my 81-year-old mother-in-law takes. Her forgetfulness has gotten progressively worse, and she is dizzy much of the time.

She is taking: amitriptyline, Aricept, Arthrotec, aspirin, Avapro, Chlor-Trimeton, Levothroid, Lexapro, Lortab, Norvasc, Symbicort and Tylenol Arthritis. Do you see any red flags?

A: You have reason to be concerned. Her medications might be contributing to her dizziness and mental decline. Amitriptyline is prescribed for depression or pain relief. It is rarely appropriate for older people, as it may increase forgetfulness and confusion. The antidepressant Lexapro might push levels of amitriptyline higher than expected.

Both blood-pressure medicines (Avapro and Norvasc) can cause dizziness. So can the pain reliever Lortab. If dizziness caused a fall, it could be devastating.

She is getting a double dose of acetaminophen from Lortab and Tylenol Arthritis. This could put a strain on her liver.

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 via their Web site: www.peoplespharmacy.org