Consumer Reports has published a valuable article identifying common prescription drugs that can be dangerous for older patients. Healthcare consumers over age 65 are more than twice as likely to suffer from adverse drug reactions; the publication lists the following drugs as posing a high enough risk that they should be avoided if possible:

• Antianxiety drugs

  Chlordiazepoxide (Librium, Limbitrol); diazepam (Valium); quazepam (Doral)

  Recommended alternatives: alprazolam (Xanax), lorazepam (Ativan), and oxazepam (Serax)

• Antidepressants

  Amitriptyline, doxepin (Sinequan) and Fluoxetine (Prozac)

  Recommended alternatives: citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft)

• Antihistamines

  Chlorpheniramine (Chlor-Trimeton); diphenhydramine (Benadryl)

  Recommended alternatives: Cetirizine (Zyrtec); fexofenadine (Allegra); loratadine (Claritin)

• High blood pressure and enlarged prostate drugs

  Doxazosin (Cardura); prazosin (Minipress); terazosin (Hytrin)

  Recommended alternatives: Diuretics for high blood pressure; tamsulosin (Flomax) for enlarged prostate.

• Pain relievers

  Naproxen (Aleve, Naprosyn); oxaprozin (Daypro); piroxicam (Feldene); Meperidine (Demerol)

  Recommended alternatives: acetaminophen (Tylenol); ibuprofen (Advil ); capsaicin cream (Zostrix); morphine

• Sleeping pills

  Barbituates (Butisol, Nembutal, Seconal); diphenhydramine (Sominex); flurazepam (Dalmane)

  Recommended alternatives: zaleplon (Sonata) and zolpidem (Ambien)

• Stomach drugs

  Bisacodyl (Dulcolax); Diphenoxylate (Lomotil)

  Recommended alternatives: Increased intake of fiber and fluids; change in diet; loperamide (Imodium AD)

I stumbled across this while reading Gawker: “Teen socialite” Peaches Geldof says the staff at the fashion magazine Nylon prefer prescription drugs over illegal drugs –

What’s the drug of choice at Nylon? “Klonopin.” Peaches was definitely the talky one. Why? “It’s just a very large prescription drug culture.”…

This confirms our highly anecdotal evidence of Klonopin as a mini-trend for the creative underclass, maybe better than Xanax—not that our shrink is offering to prescribe us any despite repeated inquiries.

Klonopin, classified as a “sedative-hypnotic,” is prescribed for epilepsy, panic and anxiety disorders, restless legs syndrome and other medical conditions. Unfortunately, such drugs are too easily obtained by young people, who often start taking them by raiding their parents’ medicine cabinets.

As Ritch Wagner of Purdue Pharma (OxyContin), who educates medical professionals and law enforcement officials about the dangers of prescription drug abuse, describes the growing problem:

More prescription drugs are creeping up the list of the 20 most widely abused substances, Wagner said, including the painkiller hydrocodone and methadone, a narcotic commonly used to treat heroin addiction that is now used to treat pain.

Abusers are beginning to learn it can “be more advantageous” to use prescription drugs to get high than drugs such as meth, cocaine and heroin. They are easier to obtain, and people think they are safe because doctors prescribe them.

“In my day and age, it was how many of Dad’s beers we can sneak out of the fridge,” Wagner said. “Now, it’s how many pills can I get out of the medicine cabinet.”

Wagner said children are taking whatever pills they can get their hands on, throwing them into a bowl and taking a handful. They’re called punch-bowl or grab-bag parties.

I think what really struck me about these stories was Geldof’s use of the term “prescription drug culture.” I hadn’t heard the term before.

My immediate reaction was to compare it to the “drug culture” of the ’60s and early ’70s, which we relate to young people — specifically, “hippies.” But upon reflection, the “prescription drug culture” isn’t confined to the young in our country today. It’s pervasive.

It starts with the billions of dollars in advertising that pharmaceutical companies spend to get us to stock our medicine cabinets with drugs — drugs that we might or might not really need.

Before the recent advertising campaign, for example, I’m guessing you’d never even heard of restless legs syndrome — let alone gone to the doctor and asked for Klonopin or Mirapex. The medical use of drugs like Xanax and Prozac have gone through the roof among adults of all ages. And don’t you suspect the Viva Viagra! advertising campaign has made Viagra an object of curiosity not only among middle-aged men, but among teenage boys?

When a teenager’s parents, as well as all of his or her friends’ parents, are stocking the medicine cabinet with these drugs, don’t you think what happens next is almost inevitable?

So, how do we solve the problem? Frankly, as I’ve stated here before, I would put an end to direct-to-consumer advertising by pharmaceutical companies.

Others may disagree with this approach, and that’s fine. But however we get there, we need to reach a point where we don’t expect a “pill for every ill.” Because if you believe there’s a pill for every ill, it’s a short step to believe that prescription drugs are the answer for everything — including having a good time at a party.

Here are those five medications, in order of searches:

1. Lexapro
2. Effexor
3. Cymbalta
4. Prozac
5. Paxil

So, which antidepressant is right for you? In addition to consulting your physician, here are two helpful resources:

1. The Mayo Clinic offers an excellent overview of your options and considerations in making a decision.

2. Dinah at Shrink Rap, a blog by psychiatrists, explains how she matches patients with a particular antidepressant.

The second resource should be of particular value before you discuss a prescription with your doctor or psychiatrist.

• Zoloft
• Viagra
• Cialis
• Mirapex (restless leg syndrome)
• Lipitor
• Valtrex

Whether the individual doctors did anything wrong, however, patients can get in trouble when they go to multiple doctors — which is increasingly the case in today’s world.

That’s why it is important to take the safety of your drug regimen in your own hands through a sophisticated tool like PharmaSurveyor (now in beta) or some of the other drug-interaction tools currently on line, like this one at DoubleCheckMD .

Frankly, it’s surprising to me to see this kind of anti-Big Pharma slant from Fox News. We’ll see where they go with the story.

Expect those numbers to continue climbing. Last week, the FDA approved the drug as an add-on treatment for adults with major depressive disorder. The drug is to be used in conjunction with commonly prescribed anti-depressive therapies, including the SSRIs Lexapro, Prozac, Paxil CR, and Zoloft.

1. High Blood Pressure
2. Abilify
3. Provigil
4. Yasmin
5. Lipitor
6. Lamisil
7. Synthroid
8. Levitra
9. Phentermine
10. Vytorin
11. Topamax
12. Meridia
13. Zoloft
14. Crestor
15. Xenical
16. Zetia
17. Prevacid
18. Lisinopril
19. Viagra
20. Plavix
21. Cialis
22. Singulair
23. Risperdal
24. Diovan
25. Casodex

The list isn’t a perfect reflection of the most popular drugs purchased online, largely because of Google. For a variety of reasons, eDrugSearch.com appears very high in the organic search results for some drugs, but not as high for others. This obviously skews our results.

With this caveat, however, we hope that over time our results will shed light on trends in online drug sales.

We plan to post our October results in the first week of November.

We’re not sure about Rush, but apparently the hillibillies have moved on — to hydrocodone. According to the AP:

As OxyContin came under scrutiny, doctors were more careful about how they prescribed it. Many switched to hydrocodone products, which were already popular but didn’t have the same stigma.

All 50 states saw increases in the distribution of hydrocodone between 2001 and 2005. But the trend was particularly significant in the South, where all of the top 10 states in terms of increased distribution are located, the DEA says. Four of the top five — Tennessee, West Virginia, Kentucky and Alabama — include parts of Appalachia.

Authorities say hydrocodone is so popular in this region partly because it’s easy to acquire. Street drugs like heroin are harder to come by in sparsely populated rural areas. Prescription painkillers can be found at every pharmacy and pain clinic, as well as ordered over the Internet.

“When I started in this field, the primary client was involved with alcohol,” says David Bailey, a community resource specialist with the West Virginia Prevention Resource Center. “I wish it were still alcohol. Not that that’s not a very dangerous drug, but the addiction (to painkillers) seems to be much more intense, much more severe within a shorter period of time.”