Pharmacosexology: Psychiatric Side Effects of Drugs for the Treatment of Sexual Dysfunction

Objectives: To create easy to understand, antidepressant medication decision making aids and describe the process used to develop the aids for patients diagnosed with depression. Methods: In collaboration with the Institute for Clinical Systems Improvement (ICSI), antidepressant medication decision making aids were developed to enhance patient and physician communication about medication selection. The final versions of the aids were based on design methods created by Dr. Victor M. Montori (Mayo Clinic) and discussions with patients and providers. Five physicians used prototype aids in their outpatient clinics to assess their usefulness. Results: Six prototype antidepressant medication decision making aids were created to review potential side-effects of antidepressant medications. The side effects included were those patients feel are most bothersome or may contribute to premature discontinuation of antidepressant treatment, including: weight changes, sexual dysfunction, sedation, and other unique side effects. The decision aids underwent several revisions before they were distributed to physicians. Physicians reported patients enjoyed using the decision aids and found them useful. The sexual dysfunction card was considered the most useful while the daily administration schedule card was felt to be the least useful. Conclusions: Physicians found the antidepressant decision making aids helpful and felt they improved their usual interactions with patients. The aids may lead to more patient-centered treatment choices and empower patients to become more directly involved in their treatment. Whether the aids improve patient's medication adherence needs to be addressed in future studies. Type: Student Project

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Psychiatric side effects induced by supraphysiological doses of combinations of anabolic steroids correlate to the severity of abuse

European Psychiatry ◽

10.1016/j.eurpsy.2005.09.001 ◽

2006 ◽

Vol 21 (8) ◽

pp. 551-562 ◽

Cited By ~ 69

Author(s):

Thomas A. Pagonis ◽

Nikiforos V. Angelopoulos ◽

George N. Koukoulis ◽

Christos S. Hadjichristodoulou

Keyword(s):

Side Effects ◽

Anabolic Steroids ◽

Linear Regression Analysis ◽

Control Group ◽

Time Interval ◽

Psychological Consequences ◽

Psychometric Instruments ◽

Wide Range ◽

Significant Difference ◽

Psychiatric Side Effects

AbstractObjectiveThe objective of our study was to evaluate the psychological consequences of real-world AAS use in athletes abusing such agents, in comparison with a placebo and control group of comparable athletes, while correlating the severity of abuse with the side effects observed. The hypothesis tested by the study was that the use of AAS induces a wide range of psychological side effects whose impact and emergence is dependent upon the severity of the abuse.DesignThe study includes a substantial group of AAS abusing athletes and two more groups demographically similar to the first, one composed of athletes not using any substance and a placebo group. All athletes were stratified according to the severity of AAS abuse. Psychometric instruments were applied to all athletes in specific time intervals, dependent to the AAS abusers' regimens, providing us with a final psychological profile that was to be compared to the pre-study profile. All results were comparable (within and between groups) for statistically significant differences and correlated to the severity of the abuse. Homogeneity of all groups was safeguarded by random doping controls, monitoring of drug levels and analysis of all self obtained drugs by method of liquid chromatography/mass spectrometry. All athletes were provided with a common exercise and dietary regime, so common training and nutritional conditions were achieved.MethodsWe studied a cohort of 320 body-building, amateur and recreational athletes, of whom 160 were active users of AAS (group C), 80 users administering placebo drugs (group B) and 80 not abusing any substance (Group A). Group C athletes were stratified according to AAS abuse parameters, thus providing us with three subgroups of “light, medium and heavy abuse”. Athletes of groups A and B were included in a “no abuse” subgroup. The psychometric instruments used were the Symptoms Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ). The psychometric evaluations took place within a time interval of 13 months. Statistical analysis was performed by using the Mann–Whitney/Wilcoxon two-sample non-parametric test (Kruskal–Wallis test for two groups) for data that were not normally distributed and Linear regression analysis was used to ascertain the correlation between severity of use and escalation of side effects.ResultsThe study showed a statistically significant increase in all psychometric subscales recorded in group C, and no statistically significant difference in group C and A. There was a significant increase in the scorings of group C for all subscales of SCL-90 and HDHQ. Correlation of abuse severity and side effects showed that there was a statistical significant increase in Δ values of all SCL-90 and HDHQ subscales that escalated from light abuse to medium and heavy abuse/consumption patterns.ConclusionsThe results of the study suggest that the wide range of psychiatric side effects induced by the use of AAS is correlated to the severity of abuse and the force of these side effects intensifies as the abuse escalates.

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Rosa Damascena Improved Sexual Dysfunction in Males Under Methadone Treatment – Results from a Double-Blind, Randomized, Placebo-Controlled Clinical Trial

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.129 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S281-S281

Author(s):

V. Farnia ◽

F. Tatari ◽

M. Alikhani ◽

J. Shakeri ◽

M. Taghizadeh ◽

...

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Sexual Dysfunction ◽

Methadone Treatment ◽

Controlled Clinical Trial ◽

Rosa Damascena ◽

Placebo Condition ◽

Double Blind ◽

Male Patients ◽

Competing Interest

IntroductionPatients with severe opioid dependency might be treated with methadone, a pure μ-opioid-receptor, with promising results. Though, as for opioids, side effects are high, and among those, sexual dysfunction is among the most disturbing side effects.AimsInvestigating the influence of Rosa Damascena oil to improve sexual dysfunction among male methadone users.MethodsA total of 60 male patients (mean age: 30 years) with diagnosed opioid dependence and currently under treatment of methadone were randomly assigned either to the verum (Rosa Damascenca oil drops) or placebo condition. At baseline, and four and eight weeks later, patients completed self-rating questionnaires covering sexual dysfunction and happiness.ResultsOver time sexual dysfunction decreased and happiness increased in the verum, but not in the placebo condition.ConclusionsResults from this double blind, randomized, and placebo-controlled clinical trial showed that Rosa Damascena oil improved sexual dysfunction and happiness among male opioid addicts while under substitution treatment with methadone.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sexual dysfunction and mood stabilizers in bipolar disorder: A review

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1682 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s849-s849 ◽

Cited By ~ 1

Author(s):

C. Gómez Sánchez-Lafuente ◽

R. Reina Gonzalez ◽

M. Hernandez Abellán

Keyword(s):

Bipolar Disorder ◽

Medication Adherence ◽

Side Effects ◽

Sexual Dysfunction ◽

Clinical Studies ◽

Side Effect ◽

Small Sample ◽

Mood Stabilizers ◽

Cochrane Library ◽

Short Period

IntroductionMood stabilizers can cause many side effects. Although many of these are well known, like thyroid and renal failure after taking lithium, sexual dysfunction side effects remains unclear.MethodsWe made a systematic computerized literature search of clinical studies using MEDLINE, The Cochrane Library and Trip for clinical studies of sexual dysfunction published up to December 2015.ResultsOnly eight relevant papers were identified. All of them studied lithium sexual dysfunction in bipolar disorder patients. Valproic acid, carbamazepine and lamotrigine were not studied in patients with bipolar disorder. Nevertheless, the three were studied in epilepsy. Clinical reports usually used Arizona Sexual Experience Scale or Psychotropic Related Sexual Dysfunction Questionnaire to measure sexual dysfunction and Brief Adherence Rating Scale to measure medication adherence. They suggest lithium could decrease desire and sexual thoughts, worse arousal and cause orgasm dysfunction. In overall, those patients with sexual dysfunction had lower level of functioning and poor compliance. Taking benzodiazepines during lithium treatment may increase the risk of sexual dysfunction even more.ConclusionThere are few studies that focus on mood stabilizers sexual dysfunction. This inevitably entails a number of limitations. First, the small sample size and, in some studies, the relative short period of follow-up may underestimate the results. Besides, practical management was not treated in any study. Actually, handling this side effect have not been well established.To conclude, this revision suggest that approximately 30% patients receiving lithium experience this side effect, and it is associated with poor medication adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Cancer Pain Management, Opioid Side Effects, Endocrine Changes, and Sexual Dysfunction

Encyclopedia of Pain ◽

10.1007/978-3-642-28753-4_534 ◽

2013 ◽

pp. 380-382

Author(s):

Russell K. Portenoy ◽

Ebtesam Ahmed

Keyword(s):

Pain Management ◽

Side Effects ◽

Sexual Dysfunction ◽

Cancer Pain ◽

Cancer Pain Management

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