Quinine in tonic cured cramps

Q. I have had severe leg cramps for years. My doctor used to prescribe quinine until the Food and Drug Administration banned it for that use.

My pain got so bad, I finally gave in and went to the doctor last week. She ran a lot of tests and then told me to drink two glasses of tonic water with added lime slices daily.

I’m happy to report that I’ve been cramp-free since that day! And I really like the taste of my concoction.

A. There is a small amount of quinine in tonic water. Two 8-ounce glasses would contain about 40 mg, roughly one-fifth of the dose of quinine your doctor used to prescribe in pill form.

Others also have reported success with tonic water, but we must warn you that some people are super-sensitive to this compound. If you experience headache, nausea, rash, dizziness, blurred vision or ringing in the ears, stop immediately. Blood disorders linked to quinine are rare, but could be life-threatening if allowed to continue.

People who can’t tolerate tonic or don’t get relief may find our Guide to Leg Pain helpful. It can be downloaded for $2 from www.peoplespharmacy.com.

Q. I read on your website that the sleeping pill Ambien can cause acid reflux. I have been taking Ambien for about 20 years. I have terrible reflux.

After reading your article, I realized my heartburn started at the time I started taking Ambien. Do you think that eventually (I have been off it for one week) my acid reflux might clear up?

Ironically, it is the same doctor who has been prescribing the acid-reflux medicine that also has been prescribing the Ambien.

A. Zolpidem (Ambien) remains one of the most popular prescription sleeping pills on the market. There is relatively little awareness that the drug can cause gastroesophageal reflux disease.

The official prescribing information mentions that dyspepsia (the medical term for heartburn) is a frequent side effect, but your doctor would have had to dig to find it. A study in the journal BMJ Open (Feb. 27, 2012) describes “regurgitation” brought on by zolpidem and warns that this might damage the esophagus and increase the risk of cancer.

One reader shared this story: “I went through hell as a result of Ambien. I had about $40,000 in medical bills from all the diagnostic tests and procedures. Nobody could figure out what was causing the reflux. Four weeks after stopping Ambien, I was totally cured of all my symptoms.”

Q. I am currently taking antidepressants and was taking them when I had my stroke. My deficits were minor, and the EMTs and doctors were surprised at the speediness of my recovery. Could antidepressants have protective effects?

A. Research has shown that when antidepressants like escitalopram (Lexapro) were given after a stroke, patients recovered cognitive skills and memory faster than patients on placebo (Archives of General Psychiatry, February 2010).

A more recent investigation confirmed your experience. People taking SSRI-type antidepressants (fluoxetine, paroxetine, sertraline, etc.) prior to their stroke had better outcomes than patients given such drugs after the stroke occurred (Journal of Stroke and Cerebrovascular Diseases, August 2015).

A review of the available research concludes that these drugs reduce anxiety, disability, depression and neurological impairment after a stroke, though bigger and better trials are needed to confirm the initial results (Cochrane Database of Systematic Reviews, Nov. 14, 2012).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”