Erectile dysfunction and those antidepressants.

August 28th, 2008

Just to repeat the general messageof these books: when you are aged between forty and seventy years, you have a fifty/fifty chance of experiencing some degree of ED. Many people will lose thier erection at all. Alongside this news is the equally significant evidence of depressive illnesses. Researchers estimate that about a quarter of men will suffer some degree of anxiety or depression at some point during their lives. When this happens, the symptoms may not appear too serious and you will probably not seek treatment. But you are twice as likely to suffer decreased libido and ED than someone not depressed, leading you to reduce or avoid sexual contract for a while. Many of you will leave the depression, if such it is, untreated and buy Viagra, Cialis or Levitra online. This is an entirely understandable reaction. But it is always better to get a professional opinion before self-medicating.

This creates real problems for the physicians trying to balance treatments for both the depressive illnesses and the ED. Because there may be adverse reactions between the different medications, you should not take Viagra, Cialis or Levitra on your own initiative if you are already taking any other medications. Your physician has a number of options:

  • The best, and may be not very reliable way is to change your antidepressant to another, with other side-effects. If you respond well to either of these, you may find that you feel less depressed and your sexual performance improves. Wellbutrin is also less likely to cause weight gain which may aid your choice of medication.
  • It may be possible to lower the dose of the current antidepressant so that you still get some relief from the depression and your sexual performance improves. For example, in one clinical trial of Prozac (fluoxetine hydrochloride) some people responded as well to a dosage of 5-10mg as the more usual 20mg.
  • If you do seek advice and a depressive illness is confirmed, your physician will offer treatment. In such cases, the issue of cause and effect can become complicated. The ED may have been caused by the anxiety or depression itself, or there may have been an independent cause. But what began as a small problem can be aggravated as a side effect of the antidepressant medications you are prescribed. It is somewhat ironic that one of the factors depressing you may be your declining sexual performance, but the treatment for that depression can complete deprive you of your desire to have sex. As if it could get worse, the selective serotonin reuptake inhibitors (SSRIs) antidepressants not only affect sexual performance, but may also disturb sleep patterns and cause weight gain. Not surprisingly, this prompts many patients to stop taking the medication. Thus, although treatment using one or more antidepressants is usually successful in 90% of all cases, less than one third of patients complete the course of medication, and the incidence of relapse is high.

    With some drugs, e.g. Zoloft (sertraline) and Anafranil (clomipramine), it may be possible to change the medication regime. If you have a fairly consistent time when you engage in sexual activity, this should be timed when the drug’s level in your body would be at its lowest, i.e. you would take your daily dose after sexual intercourse.

    There are some case reports and small clinical studies that have found some additional medications can modify the effect of the antidepressant. For example, in an off-label test, Amantadine has been shown to relieve the SSRI-induced inability to reach an orgasm in some but not all people.

    All this has assumed that the ED was in fact caused by the depression or the medication to treat that depression. If there are alternative explanations for the ED, those should also be thoroughly investigated. It would compound the irony if the true cause of your ED should prove not to be the antidepressants but a condition requiring a different treatment.

No-one takes any notice of adverts, do they?

August 26th, 2008

It is easy to disband advertising as having little effect on consumer behaviour which is why companies spend so much on advertising. In the medical field, the adverts are intended to achieve specific goals:

  • to aknowledge links between everyday experiences and medical causes; and
  • to believe that the branded medications will remove the causes and return you to your normal state.

The first adverts appeared in the end of the XX century, the FDA imposed a moratorium to research the effect of the advertisements on people. In 1985, the moratorium was lifted because of fears that it was interfering with freedom of speech.

In the area of erectile dysfunction, the advertising for cialis runs through a number of different forms. Like any prescription medication, it is aimed at delaying the sympthom of your physical condition. The wording proclaims, “It works!” as if that explains all the benefits of the medication.

There is no doubt that this advertising educates the public about their options when faced by health problems and teaches them to believe that taking a pill is the best solution. When that medication is only available on prescription, it promotes business to the doctors. In the case of cialis, it is interesting to note that the FDA has never queried any of the adverts whereas there has been litigation alleging misleading advertising for competing medications. Add to this the fact that the word-of-mouth advertising for cialis has been and remains very strong, and it is easy to understand why this medication has taken so big a slice of the market so quickly.

These simple statements are often combined with personal testimonials and confirmation that use of the medication avoids the feared outcome, in this case, a failure to penetrate or maintain the erection after penetration. This tends to be the core appeal. If erectile dysfunction is the problem, cialis helps you to function normally again. By introducing others as victims, guilt at not getting the “cure” is increased - cure is life-enhancement for both partners. To support this, people are encouraged to begin the art of self-diagnosis and health management. The adverts give a few symptoms and suggest that those symptoms represent a disorder that can then be “cured”. It is uncommon to find the price of the medication mentioned, or any information about whether it is available on health insurance plans.

In the beginning…

August 19th, 2008

First description of erectile dysfunction was found on Egyptian papyrus dating to around 2000 B.C.E. These writing describe two types of impotence: the first was “natural”, meaning the man was simply incapable of an erection. The second was the result of influence of evil magic, it called “supernatural”.

Impotence in the seventeenth century changed the face of Western civilization. The Spanish Hapsburg Empire reigned supreme over much of the world for centuries. Their downfall was attributed to the impotence of their final leader. Unable to keep it up long enough to propagate the lineage, Don Carlos II sought all available impotence treatments including exorcisms. Since his impotence endured, the Hapsburg lineage-and empire-did not.

Other historical figures rumored impotent include Kings Richard I and Louis XVI, George Bernard Shaw, Sigmund Freud, Napoleon, Beethoven, and Rousseau. Rousseau’s 1762 essay “Discourse on the Arts and Sciences” argued that the advancement of science and medicine had not been beneficial to mankind. FDA approved Viagra in the eighteenth century he would have felt differently. Edgar Allen Poe’s most famous line, “Nevermore”, referred to his love life.

There is a curious fact that apparently, no american president has trouble with erections while living in the White House - at least not the lack of them.

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