Why do so many drugs stop working? | Peoples Pharmacy | swoknews.com – The Lawton Constitution

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Updated: March 11, 2022 @ 5:28 am

You probably have heard the term “tolerance.” In common parlance, it means that you are willing to put up with beliefs or behaviors that you might not like or agree with. Religious tolerance implies that you can appreciate values and practices that may differ from your own.
Drug “tolerance” is completely different. It means that your body gradually stops responding to a medication. Doctors often have to increase the dose to obtain the same benefits.
The classic example is an opioid pain reliever. Patients who suffer from severe chronic pain associated with cancer are sometimes administered morphine. Over time, their bodies may become less responsive to the pain-relieving properties of the drug. Doctors have to keep increasing the dose to maintain a reasonable degree of comfort.
A surprising number of other medications can also lose their effectiveness. Asthma drugs called bronchodilators open airways. These rescue inhalers relax smooth muscle in the lungs to relieve an acute attack of asthma. Drugs like albuterol, fenoterol and salmeterol provide rapid symptom relief. But if used too frequently, the effectiveness can fade.
Antidepressants also may become less effective for some people over time. For reasons that are somewhat mysterious, patients who take a medication successfully for years may eventually discover it is no longer working.
Prozac (fluoxetine) is one of the most frequently prescribed antidepressants in the world. When fluoxetine becomes less effective, people sometimes refer to it as “Prozac poop-out.”
One reader offered this report: “I have been on Prozac for approximately five years. I began with 20 milligrams but recently, with my doctor’s OK, I increased the dose to 40 milligrams. The lower dose wasn’t working any more. Though I have been on the higher dose for about three months, it is not helping either.
“Is my body not responding to this drug anymore? Should I be switched to another drug? I am not sure my family doctor knows what to do, and I don’t have a psychiatrist.”
Another reader brought up a different aspect of this problem: “I have been taking the antidepressant sertraline for years, but it doesn’t seem to be working anymore. The trouble is that when I try to stop taking it, I experience incredible side effects. The dizziness is unbearable. To walk across a room, I have to hold on to furniture. My pulse is racing, and I have a pounding headache.
“Taking the drug again makes the symptoms disappear, but my mood is no better. Is this drug addicting? I would love to find something else that could alleviate my depression.”
The Food and Drug Administration refers to antidepressant withdrawal symptoms as “discontinuation syndrome.” People may experience electric shock sensations, sweating, irritability, anxiety, nausea, insomnia, tremor and confusion.
Researchers do not understand why some people stop responding well to an antidepressant. Perhaps the treatment changes serotonin receptors in the brain.
If increasing the dose doesn’t work, doctors often add a different antidepressant. Although this can sometimes be effective, it may also be risky.
When a medication no longer seems to be helping as it once did, patients should discuss the problem with the prescriber. Perhaps a completely different medicine or a nondrug approach will be more useful.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com.
— King Features
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