For instance, patients on P.P.I.s (proton pump inhibitors) — like Prilosec, Nexium and Prevacid for GERD — need to understand that once on these medications for any length of time, it is very difficult to get off them because symptoms return worse than before. Better not to start on them at all.

Here’s another example: I would only use antidepressants for very severe depression and then only for a year at most. With long-term use, they can intensify or prolong depression. For mild to moderate depressions I would try other measures: regular exercise, reducing caffeine, acupuncture, cognitive therapy, vitamins B and D, St. John’s Wort, fish oil — and spending more time in the company of happier people.

I believe that if you present information to people in the right way, they will get it. Some alternatives to medications work quickly. For instance, stinging nettle works just as fast as any antihistamine for hay fever, without any of the downside of the antihistamine.

Q. What about over-the-counter products and supplements?

A. When we see patients at our integrative medicine clinic, we ask people to bring in everything they’re taking — and they come in with shopping bags full. A lot of what’s sold over-the-counter now includes drugs that originally were prescription only, but people think O.T.C. drugs are benign and without the risks of prescription drugs.

A lot of people are also taking dietary supplements and herbal remedies from natural products, without considering the interactions with prescriptions and other O.T.C. products. There are additive blood-thinning effects (fish oil or vitamin E taken with Coumadin), additive sedative effects (valerian used with antihistamines) and the prolongation or intensification of drug effects (St. John’s wort and S.S.R.I. antidepressants).

Q. What O.T.C. products should we really worry about and why?

A. Let’s start with NSAIDs (non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen and naproxen). These are strong drugs and can be very useful for short-term management of conditions, but they carry some very severe risks of increased bleeding and other cardiovascular and kidney problems.

Then there are the P.P.I.s, originally prescription-only, but now available in over-the-counter forms like Nexium. People should not get on these drugs in the first place. They’re very high risk for dependence, and there are a lot of other problems with them.