> -----Original Message-----
> From: Catherine Knutsson [mailto:bachsoprano@t...]
> Sent: Sunday, September 08, 2002 7:10 PM
> To: Vocalist List
> Subject: [vocalist] Medications and the voice
>
I am interested in
> anti-depressants (Prozac and Adavan (sp?) to be specific) and
> birth-control pills...
I don't want to reinvent the wheel so I will refer you to Dr. Sataloff's
excellent review:
http://www.upmc.edu/UPMCVoice/SataloffMed.htm
I will add however, that his reference to antihypertensive (for high
blood pressure) medications is a little outdated. We generally do not
use diuretics in doses that dehydrate nowadays and I have not used
methyldopa or reserpine in 10 years or more.
Regarding birth control pills, women vary in their response. A singer
should ask her doctor to try to stick to one of the less androgenic
progestational agents now available in numerous brands. If the doctor
can not identify these, she/he should not be prescribing birth control
pills.
Prozac and other antidepressants should not directly affect the voice
but everyone is different. One thing that can occur is one's response
to the antidepressant - I have had to adjust medications because while
the depression is gone, so is the personality. One must find the
balance that treats only the problem.
Ativan is an antianxiety drug. It can reduce inhibitions and nerves but
can also be addictive.
>This also leads me to a question about ethics.....when should a voice
> teacher advise students about such things? Most of the general
> practioners I have run into don't know much about medications and
> effects on the voice and so have not been very helpful when I have
> enquired in the past. Should I just direct the students to the
> appropriate information and let them discuss it with their doctors?
Someone posted my comments from about a year ago on this topic. I agree
that the medical needs of singers is an area where many doctors,
including ENT's, may not have much interest. It is difficult for one
not specifically interested in singing to understand the difference
between just being able to speak and singing. That's one reason for
forums such as Vocalist.
> Also, what about students
> who are self-medicating with herbal remedies?
The problem with many herbals is the knowledge is anecdotal. As more
are being tested scientifically, toxicities are being found. One must
approach these with caution and seek knowledgeable sources for
information on individual herbs/plants.
And, what
> about the more
> mundane sorts of medications, such as cough and cold
> remedies? Should a
> voice teacher enter into this, or should one just keep their
> hands clean?
>
I do think the voice teacher is in a position to evaluate the voice of
the student. If there is a problem and there has been a medication
introduced, the teacher could certainly suggest the student ask the
doctor if it is possible that the medication is a problem.
Hope that helps.
John
John Messmer, M.D.
Assistant Professor, Family and Community Medicine
Penn State Hershey Medical Center
|
|  |
