Q. A study published in the British Medical Journal suggested that taking the antidepressant amitriptyline raised the risk of dementia.
I asked my GP, who just said: ‘I’ve not read the report.’ So I have stopped taking the drug. Am I doing the right thing?
A. It is vital to talk through stopping any medications with a GP. If yours isn’t understanding, speak to another doctor.
As for whether these antidepressants cause dementia, here are the facts.
Over the past few years there has been considerable discussion about long-term side effects of medication and unwarranted effects such as increasing risks of disease.
It is vital to talk through stopping any medications with a GP. If yours isn’t understanding, speak to another doctor
It is very important when taking any medication for patients to weigh up the benefits and the risks. It is a balancing act.
Amitriptyline is one of a group of drugs known as anticholinergics and it is used to treat depression, pain and insomnia.
In April a large study was published in the BMJ looking at the role of anticholinergics and the development of dementia.
The conclusion was there is an association between taking the medicine and a higher chance of developing dementia: the normal risk of ten per cent for a population rose to 13 per cent in those taking it, so out of 100 people, an extra three would be diagnosed.
Of course, one more is too many.
But delving further into the study reveals an interesting potential reason for this.
Amitriptyline is one of a group of drugs known as anticholinergics and it is used to treat depression, pain and insomnia
Amitriptyline can be prescribed for depression and other symptoms that may be the very early signs of dementia, years before a definite diagnosis is apparent.
It is therefore possible that patients who will go on to develop dementia in later life are more likely to have been prescribed the drug: the early stages of the disease caused the need for amitriptyline rather than amitriptyline causing the dementia – an association rather than a cause.
Further research is needed to prove or disprove that it is indeed a risk.
In April a large study was published in the BMJ looking at the role of anticholinergics and the development of dementia
Q. I have been suffering from plantar fasciitis for eight months and nothing seems to get rid of my heel pain.
A. Plantar fasciitis is inflammation of the plantar fascia – a strong band of tissue that stretches from the heel to the middle foot, supporting the arch of the foot and acting as a shock-absorber.
It’s a debilitating condition that will affect one in ten at some point, causing pain on the sole of the foot and heel. Weight contributes to the issue due to the pressure on the feet, but it is a common condition in runners or those whose jobs involve standing for long periods.
Unfortunately there is no one single treatment, but rather a range of options. This can be frustrating and it can often be eight weeks before any improvement is seen, but 80 per cent of those with the condition will improve in 12 months.
Physiotherapy is recommended to stretch the Achilles and the calf muscles. Orthotic insoles may offer relief from raising the heel and arch support, although the scientific evidence for their success is not compelling.
Anti-inflammatories are useful for pain relief, as is ice, and regular rest and supportive sports shoes are important. When these measures are not helping, a steroid injection can be considered.
There is also shockwave treatment and surgery if the symptoms persist and daily pain becomes debilitating.
Mela-NO-ma, Dr George!
I’m worried about junior doctor Alex George, right, as he is putting himself at risk in the Majorca sun: he appears to be the only one going red – not a good look for a healthcare professional
I am addicted to Love Island despite the preening, improbably perfect bodies, the power play and bullying, and what it says about relationships today.
But I’m worried about junior doctor Alex George, right, as he is putting himself at risk in the Majorca sun: he appears to be the only one going red – not a good look for a healthcare professional.
Current advice is to use at least SPF 30 in the Mediterranean sun.
Alex has won everyone over with his respectful attitude to the women, but he is not doing his health or chances of finding love much good by avoiding sun block.