Question

A 71-year-old woman was recently diagnosed with hypercholesterolemia and depression following the sudden death of her husband of 47 years. Her medical doctor has prescribed simvastatin to help lower her cholesterol and an anti-depressant. During her doctor visit, the patient reports her diet has been erratic due to her emotional state, and decides to make some changes in her diet to improve her well-being. In addition to her usual glass of grapefruit juice at breakfast every morning, she decides to eat more vegetables with her meals. The patient’s friend has also encouraged her to try St. John’s wort to ease her depression. At her one-month follow-up visit with her medical doctor, the patient reports feeling better emotionally although she feels more tired than usual and reports occasionally feeling sick to her stomach. She is also surprised that, in spite of her improved diet, she has gained 5 pounds since her last visit. Her doctor also notes that her blood cholesterol level has decreased. And although she is on a normal dose of simvastatin, her doctor notes an unusually rapid drop in her blood cholesterol from 250 mg/dL to 155 mg/dL.

1. What may explain the patient’s weight gain?

2. What places the patient at increased risk for adverse effects from mediations?

3. What steps could Mrs. Miller’s health care team have taken to prevent adverse effects of her medications?

Answer 1

And1)people who take antidepressant medications- including the popular SSRI (selective serotonin reuptake inhibitor) drugs can cause a weight gain of 10 pounds or more

Ans2)

The most common statin side effects include:

• Headache.
• Difficulty sleeping.
• Flushing of the skin.
• Muscle aches, tenderness, or weakness (myalgia)
• Drowsiness.
• Dizziness.
• Nausea or vomiting.
• Abdominal cramping or pain.

Common side effects of selective serotonin reuptake inhibitors (SSRIs)

• feeling agitated, shaky or anxious.
• feeling and being sick.
• indigestion and stomach aches.
• diarrhoea or constipation.
• loss of appetite.
• dizziness.

Ans3)

How to relieve statin side effects

• Take a brief break from statin therapy.
• Switch to another statin drug.
• Change your dose.
• Take it easy when exercising.
• Consider other cholesterol
• lowering medications.
• Try coenzyme Q10 supplements.

How to relieve antidepressant side effects

• Take the antidepressant at bedtime.
• Avoid driving or doing activities that require vigilance if you are feeling drowsy.
• Avoid alcohol or any other substance that may cause drowsiness.