GRAEDONS | People's Pharmacy One of Prozac's side effects can be fantasies of suicide

Q. I want to tell you of my experience with Prozac so that no one else has to go through it. I had taken Xanax for several years for periodic stress. I used it only intermittently, when the stress of my job as a scrub nurse in the operating room was unbearable. This medication never caused me any problems, and I was never addicted to it.
My insurance required me to switch doctors. The new physician said that Xanax was addictive and prescribed Prozac instead. While on Prozac for only six weeks, I became a totally different person.
Increasingly, I took risks without regard to the outcome. On the way to work one day, I fantasized about how my car would look going over a bridge, with no thought of how this would affect me. I was lucid enough to recognize this as a medication problem, and I stopped taking Prozac immediately.
It took about a week to stop the risky behaviors, but at least I was aware of the nature of the drug. Not everyone reacts the same, but I think prescribers need to be more sensitive to how it can affect some patients.
A. The official Prozac label lists abnormal thinking, suicidal ideation and violent behaviors as rare but possible reactions to the drug. The Food and Drug Administration recently required that makers of anti-depressants warn prescribers to monitor children closely for personality changes.
Your experience with Prozac suggests that some adults might also be susceptible to such reactions.
Q. What, exactly, is the difference between ibuprofen and acetaminophen? For what symptoms should one be used instead of the other?
A. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), somewhat similar to aspirin. It lowers fever, relieves pain and reduces inflammation associated with sprains, strains and arthritis. Acetaminophen also diminishes a fever and relieves pain but is less likely to ease inflammation.
The biggest difference between these drugs is digestive tract upset. Acetaminophen doesn't usually cause such problems, but ibuprofen, aspirin and other NSAIDs can trigger heartburn or even ulcers. Long-term regular use of acetaminophen was recently linked to an increased risk of kidney problems.
Q. I was just prescribed lovastatin for high cholesterol. I am disappointed to see that grapefruit and its juice are "banned." Why? What would happen if I combined the two?
Is there any cholesterol medicine that does not preclude grapefruit consumption?
A. Cholesterol-lowering drugs like Mevacor (lovastatin), Zocor (simvastatin) and Lipitor (atorvastatin) are all affected by grapefruit. Blood levels of these medications rise, and there may be an increased risk of side effects.
Grapefruit blocks an enzyme that processes dozens of medicines, including BuSpar, Cordarone, Tegretol and Viagra. All may be more dangerous if grapefruit is consumed within a day or two of taking the medicine.
& copy; 2004 King Features Syndicate Inc.