9. Glucosamine and chondroitin
Why they're used: Glucosamine and chondroitin are dietary supplements that are used to relieve joint pain, improve joint function and lessen inflammation. (Both are found naturally in the human body.) Many arthritis supplements contain glucosamine and chondroitin, both of which are regulated by the Food and Drug Administration as a food rather than a drug.
How they can cause insomnia: Researchers aren't sure exactly how glucosamine and chondroitin work, but studies identify a range of gastrointestinal side effects, including nausea and diarrhea, as well as headaches and insomnia.
Alternatives: While many people take glucosamine and chondroitin, alone or together, for osteoarthritis, they may not help at all. A recent analysis of many studies of these supplements failed to find evidence that they slow joint destruction or relieve pain.
A 2010 survey of Consumer Reports subscribers found that among those who identified osteoarthritis as one of their most bothersome conditions, yoga and massage were rated twice as helpful as glucosamine and chondroitin.
If you choose to use one or both of these supplements, you should be aware that glucosamine has a longer half-life (the time it's active in the body) than chondroitin. So if glucosamine is part of your medication regimen, taking your daily dose in the morning should prevent problems with insomnia.
You may also wish to consider asking your doctor for a prescription of tramadol 50mg tablets and taking one with an acetaminophen 325mg tablet two to three times a day. This should work well to relieve pain.
Why they're prescribed: Statins are used to treat high cholesterol.
The top-selling statins are atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor) and simvastatin (Zocor).
How they can cause insomnia: The most common side effect of all types of statins is muscle pain, which can keep people who take them awake at night and unable to rest. In the worst cases, the pain caused by statins can be immobilizing.
Studies show that statins can interfere with muscle growth by inhibiting the production of satellite cells in the muscle. Muscle weakness and aches throughout the body can be symptoms of statin-induced rhabdomyolysis, a breakdown of skeletal muscle that causes muscle fibers to be released into the bloodstream, sometimes harming the kidneys.
Researchers have found that fat-soluble statins — which include Lipitor, Mevacor, Vytorin and Zocor — are more likely to cause insomnia or nightmares because they can more easily penetrate cell membranes and make their way across the blood-brain barrier, which protects the brain from chemicals in the blood.
Alternatives: If you're among the millions of older Americans who haven't been diagnosed with heart disease but are taking these drugs to lower your slightly elevated cholesterol, ask your doctor or other health care provider about making changes to your diet and getting regular exercise instead of using statins. You also might try lowering your blood levels of homocysteine — which is linked to high cholesterol — by taking a combination of sublingual (under-the-tongue) vitamin B12 (1,000 mcg daily), folic acid (800 mcg daily) and vitamin B6 (200 mg daily).
Ask the Pharmacist is written by Armon B. Neel Jr., PharmD, CGP, in collaboration with journalist Bill Hogan. They are coauthors of Are Your Prescriptions Killing You? (Atria Books).