scholarly journals Alprazolam-induced dose-dependent anorgasmia: case analysis

BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 274-277 ◽  
Author(s):  
Kenneth R. Kaufman ◽  
Melissa Coluccio ◽  
Michelle Linke ◽  
Elizabeth Noonan ◽  
Ronke Babalola ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Sexual Dysfunction ◽  
Case Reports ◽  
Case Analysis ◽  
Total Daily Dose ◽  
Sexual Dysfunctions ◽  
Compulsive Disorder ◽  
Patient Reported ◽  
Daily Dose ◽  
Dose Dependent

BackgroundSexual dysfunctions are associated with multiple medical and psychiatric disorders, as well as pharmacotherapies used to treat these disorders. Although sexual dysfunctions negatively affect both quality of life and treatment adherence, patients infrequently volunteer these symptoms and clinicians do not pose directed questions to determine their presence or severity. This issue is especially important in psychiatric patients, for whom most common psychotropics may cause sexual dysfunctions (antidepressants, antipsychotics, anxiolytics and mood-stabilising agents). There is limited literature addressing benzodiazepines, and alprazolam in particular.AimsTo report dose-dependent alprazolam anorgasmia.MethodCase analysis with PubMed literature review.ResultsA 30-year-old male psychiatric patient presented with new-onset anorgasmia in the context of asymptomatic generalised anxiety disorder, social anxiety, panic disorder with agoraphobia, obsessive–compulsive disorder, major depression in remission, and attention-deficit hyperactivity disorder treated with escitalopram 10 mg q.a.m., gabapentin 1000 mg total daily dose, lisdexamfetamine dimesylate 70 mg q.a.m., nortriptyline 60 mg q.h.s. and alprazolam extended-release 2.5 mg total daily dose. All psychotropic doses had been constant for >6 months excluding alprazolam, which was titrated from 1 mg to 2.5 mg total daily dose. The patient denied any sexual dysfunction with alprazolam at 1 mg q.d. and 1 mg b.i.d. Within 1 week of increasing alprazolam to 2.5 mg total daily dose, the patient reported anorgasmia. Anorgasmia was alprazolam dose-dependent, as anorgasmia resolved with reduced weekend dosing (1 mg b.i.d. Saturday/1.5 mg total daily dose Sunday).ConclusionsSexual dysfunction is an important adverse effect negatively influencing therapeutic outcome. This case reports alprazolam-induced dose-dependent anorgasmia. Clinicians/patients should be aware of this adverse effect. Routine sexual histories are indicated.Declaration of interestNone.

scholarly journals Lamotrigine-induced sexual dysfunction and non-adherence: case analysis with literature review

BJPsych Open ◽  
2017 ◽  
Vol 3 (5) ◽  
pp. 249-253 ◽  
Author(s):  
Kenneth R. Kaufman ◽  
Melissa Coluccio ◽  
Kartik Sivaraaman ◽  
Miriam Campeas
Keyword(s):  
Sexual Dysfunction ◽  
Literature Review ◽  
Case Reports ◽  
Case Analysis ◽  
Epileptic Seizures ◽  
Total Daily Dose ◽  
Post Traumatic Stress ◽  
Complex Partial Seizures ◽  
Anti Epileptic Drug ◽  
Sexual Histories

BackgroundOptimal anti-epileptic drug (AED) treatment maximises therapeutic response and minimises adverse effects (AEs). Key to therapeutic AED treatment is adherence. Non-adherence is often related to severity of AEs. Frequently, patients do not spontaneously report, and clinicians do not specifically query, critical AEs that lead to non-adherence, including sexual dysfunction. Sexual dysfunction prevalence in patients with epilepsy ranges from 40 to 70%, often related to AEDs, epilepsy or mood states. This case reports lamotrigine-induced sexual dysfunction leading to periodic non-adherence.AimsTo report lamotrigine-induced sexual dysfunction leading to periodic lamotrigine non-adherence in the context of multiple comorbidities and concurrent antidepressant and antihypertensive pharmacotherapy.MethodCase analysis with PubMed literature review.ResultsA 56-year-old male patient with major depression, panic disorder without agoraphobia and post-traumatic stress disorder was well-controlled with escitalopram 20 mg bid, mirtazapine 22.5 mg qhs and alprazolam 1 mg tid prn. Comorbid conditions included complex partial seizures, psychogenic non-epileptic seizures (PNES), hypertension, gastroesophageal reflux disease and hydrocephalus with patent ventriculoperitoneal shunt that were effectively treated with lamotrigine 100 mg tid, enalapril 20 mg qam and lansoprazole 30 mg qam. He acknowledged non-adherence with lamotrigine secondary to sexual dysfunction. With lamotrigine 300 mg total daily dose, he described no libido with impotence/anejaculation/anorgasmia. When off lamotrigine for 48 h, he described becoming libidinous with decreased erectile dysfunction but persistent anejaculation/anorgasmia. When off lamotrigine for 72 h to maximise sexual functioning, he developed auras. Family confirmed patient's consistent monthly non-adherence for 2–3 days during the past year.ConclusionsSexual dysfunction is a key AE leading to AED non-adherence. This case describes dose-dependent lamotrigine-induced sexual dysfunction with episodic non-adherence for 12 months. Patient/clinician education regarding AED-induced sexual dysfunction is warranted as are routine sexual histories to ensure adherence.

scholarly journals Effect of omeprazole on patient-reported outcome measures in uninvestigated heartburn: a multi-country, multi-center observational study

2021 ◽  
Author(s):  
Leonid B. Lazebnik ◽  
Sergey A. Alekseenko ◽  
Sergii M. Tkach ◽  
Yuriy M. Stepanov ◽  
Yury Marakhouski ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Reflux Disease ◽  
Short Form ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Total Daily Dose ◽  
Complete Relief ◽  
Patient Reported ◽  
Daily Dose ◽  
Clinical Conditions

Background: Heartburn occurs predominantly in the upper gastrointestinal tract and is associated with gastroesophageal reflux disease (GERD) and gastritis. Omeprazole is the most prescribed proton pump inhibitor class of medication to treat heartburn related clinical conditions. To compare the efficacy of omeprazole 40 mg (as a total daily dose) and 20 mg using patient-reported outcome measures (PROMs) in patients with heartburn due to various aetiologies like non-erosive reflux disease, GERD, gastritis, dyspepsia, functional heartburn, gastro-duodenal ulcer.Methods: Naïve patients presenting heartburn symptoms were treated with omeprazole. PROMs were assessed based on short-form-leeds dyspepsia questionnaires (SF-LDQ), work productivity activity impairment (WPAI), relief obtained using medication and, treatment satisfactory questionnaires (TSQ).Results: A total of 18,724 patients with heartburn (GERD and gastritis; n=10,509) were treated with omeprazole (Dr. Reddy’s omeprazole [DO]/generic omeprazole [GO]/branded omeprazole [BO]) 40 mg (as a total daily dose) and 20 mg. Statistical comparative analysis showed significant improvement with omeprazole 40 mg (as a total daily dose) compared to omeprazole 20 mg in SF-LDQ, relief obtained using medication among patients with heartburn. DO 20 mg showed a greater improvement under the ‘a lot’ and ‘complete’ relief category.Conclusions: Omeprazole 40 mg (as a total daily dose) presented better efficacy as compared to omeprazole 20 mg in patient reported outcomes. This study highlights omeprazole 40 mg as the preferred intervention for improving PROMs and quality of life in the treatment of heartburn related clinical conditions.

scholarly journals Sexual adverse effects with new antidepressants

1998 ◽  
Vol 22 (7) ◽  
pp. 438-441 ◽  
Author(s):  
Shameem Mir ◽  
David Taylor
Keyword(s):  
Adverse Effect ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Monoamine Oxidase ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Case Reports ◽  
Depressive Illness ◽  
Serotonin Reuptake Inhibitors ◽  
Psychotropic Agents

Sexual dysfunction is a widely recognised adverse effect of many psychotropic agents. Older antidepressants such as monoamine oxidase inhibitors and tricycles, particularly clomipramine, are known to engender sexual adverse effects. In depression, this problem is exacerbated by the occurrence of impotence and lowered libido as part of depressive illness itself. We examined evidence relating to more recently introduced antidepressants: selective serotonin reuptake inhibitors, moclobemide, venlafaxine, nefazodone, mirtazapine and reboxetine. We reviewed published trials and case reports collated from searches of Medline, PsychLit and Micromedex from 1985 to December 1997, and contacted manufacturers of new antidepressants and requested information from them.

scholarly journals Olanzapine-Induced Withdrawal Oculogyric Crisis in an Adolescent With a Neurodevelopmental Disorder

2020 ◽  
Vol 25 (5) ◽  
pp. 455-458 ◽  
Author(s):  
Kayley Liuzzo ◽  
Danielle Stutzman ◽  
James Murphy
Keyword(s):  
Pediatric Patients ◽  
Fragile X ◽  
Case Reports ◽  
Neurodevelopmental Disorder ◽  
Total Daily Dose ◽  
Clinical Factors ◽  
Oculogyric Crisis ◽  
Daily Dose ◽  
Abrupt Discontinuation ◽  
Motor End Plate

This case report describes an adolescent female with a complex psychiatric history and Fragile X syndrome who developed an antipsychotic-withdrawal emergent oculogyric crisis (OGC) in approximately 12 hours following reduction in olanzapine dose from 20 mg total daily dose to 5 mg twice daily. The team concluded that the OGC was likely related to olanzapine withdrawal based on the following clinical factors: 1) prior treatment with olanzapine 20 mg for 4 to 5 days/week for several months, without such reaction; 2) proximity of the OGC to the olanzapine dose reduction (within 12 hours); and 3) lack of recurrence with olanzapine dose increase. Additionally, her neurodevelopmental disorder and age were identified as risk factors for an acute dystonic reaction. Published case reports describe withdrawal emergent dystonia, including OGC, following abrupt discontinuation of clozapine in adults. Given structural similarities of clozapine and olanzapine it can be postulated that this phenomenon is based in muscarinic receptor function—specifically, super-sensitized muscarinic receptors may react to excessive acetylcholine upon antipsychotic discontinuation, resulting in muscle motor end plate hyperactivity. Providers caring for pediatric patients with neurodevelopmental disorders should carefully consider risks for withdrawal emergent dystonia, obtain clear medication histories, and consider slow, conservative tapers when discontinuing antipsychotics.

Antidepressant-Induced Sexual Dysfunction

2002 ◽  
Vol 36 (10) ◽  
pp. 1577-1589 ◽  
Author(s):  
Razmic S Gregorian ◽  
Katharine A Golden ◽  
Asena Bahce ◽  
Clifford Goodman ◽  
W Jacqueline Kwong ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Antidepressant Treatment ◽  
Case Reports ◽  
Data Extraction ◽  
Common Adverse Effect ◽  
Controlled Trials ◽  
Randomized Controlled

OBJECTIVE: To review the evidence regarding antidepressant-induced sexual dysfunction and address implications for treatment strategy and health plan coverage policies for antidepressant medications. DATA SOURCES: Primary articles were identified by a MEDLINE and HealthSTAR search to identify English-language studies published between January 1986 and July 2000. Search terms included sexual dysfunction or sexual function and antidepressants, fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, venlafaxine, nefazodone, bupropion, and mirtazapine. A cross-check of references cited in 10 published reviews yielded additional in-scope articles. STUDY SELECTION AND DATA EXTRACTION: Approximately 200 articles were identified, including 8 randomized controlled trials and numerous open-label studies, case series, and case reports. Of the randomized controlled trials, only 5 were designed to evaluate the incidence of sexual dysfunction associated with antidepressant treatment. Three additional randomized controlled trials included a structured assessment of sexual dysfunction within an efficacy trial. Data extraction excluded case reports, letters, and other limited study designs. A panel survey augmented published reports. DATA SYNTHESIS: Sexual dysfunction is a relatively common adverse effect of many of the antidepressants in common use today. Rates of sexual dysfunction observed in clinical practice may be higher than those reported in the product information for several agents. Selective serotonin-reuptake inhibitors (SSRIs) appear to be the class of antidepressants most likely to cause sexual dysfunction. Published studies suggest that between 30% and 60% of SSRI-treated patients may experience some form of treatment-induced sexual dysfunction. Bupropion and nefazodone appear to be much less likely to cause sexual dysfunction (≤10% of patients). Mirtazapine also appears to be associated with a low rate of sexual adverse effects. Panel results largely reflect the consensus of the literature. CONCLUSIONS: Sexual dysfunction is a common adverse effect of antidepressant treatment. Physicians should monitor their patients for antidepressant-induced sexual adverse effects, as these may affect compliance with therapy and ultimate treatment success. In addition to the consequences for patient health and well-being, managed-care organizations should be concerned with sexually related adverse effects of antidepressants, insofar as additional healthcare resources may be required to treat depressed patients in whom these adverse effects arise.

Impact of obesity on female sexual dysfunction: A remiss

2020 ◽  
Vol 16 ◽  
Author(s):  
Asma Farooq Shah ◽  
Isha Chawla ◽  
Kirti Goel ◽  
Rakesh Gollen ◽  
Randhir Singh
Keyword(s):  
Sexual Dysfunction ◽  
Female Sexual Dysfunction ◽  
Kidney Diseases ◽  
Public Health Problem ◽  
Point Of View ◽  
Sexual Disorders ◽  
Sexual Dysfunctions ◽  
Obese Women ◽  
Prevalence Of Obesity ◽  
The Impact

: The prevalence of obesity around the globe is increasing at such an alarming rate that WHO consultation on obesity designated obesity as a major unattended public health problem worldwide. Obesity is associated with a greater risk of excessive fat related metabolic and endocrinal diseases associated with different set of illness and disabilities, including type 2 diabetes, cardiovascular diseases, kidney diseases, sleep apnea, arthritis, lung diseases and sexual disorders. Obesity is found to be associated with male and female sexual dysfunctions and several studies have indicated a positive correlation between obesity and sexual dysfunction among both males and females. The relationship between male obesity and sexual dysfunction has been widely discussed, whereas a very little emphasis is laid on relationship between obesity and female sexual dysfunctions. Sexual dysfunctions are common and affects 20-50% of obese women. Particularly, female sexual dysfunction is a multi-factorial problem, including organic and psychological aspects involved into it. These disorders not only affect physical health of women but to a greater extent mental health is also affected. Considering this point of view, present review is emphasized on the impact of obesity on female sexual dysfunctions.

scholarly journals Epidemiology and aetiology of male and female sexual dysfunctions related to pelvic ring injuries: a systematic review

2021 ◽  
Author(s):  
Giuseppe Rovere ◽  
Andrea Perna ◽  
Luigi Meccariello ◽  
Domenico De Mauro ◽  
Alessandro Smimmo ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Sexual Dysfunctions ◽  
Fracture Type ◽  
Ring Fracture ◽  
Male And Female ◽  
Pelvic Ring Injuries

Abstract Introduction Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5–33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring. Methods Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: “Pelvic fracture,” “Pelvic Ring Fracture,” “Pelvic Ring Trauma,” “Pelvic Ring injury,” “Sexual dysfunction,” “Erectile dysfunction,” “dyspareunia,” and their MeSH terms in any possible combination. The following questions were formulated according to the PICO (population (P), intervention (I), comparison (C), and outcome (O)) scheme: Do patients suffering from pelvic fracture (P) report worse clinical outcomes (C), in terms of sexual function (O), when urological injury occurs (I)? Is the sexual function (O) influenced by the type of fracture (I)? Results After screening 268 articles by title and abstract, 77 were considered eligible for the full-text analysis. Finally 17 studies that met inclusion criteria were included in the review. Overall, 1364 patients (902 males and 462 females, M/F ratio: 1.9) suffering from pelvic fractures were collected. Discussion Pelvic fractures represent challenging entities, often concomitant with systemic injuries and subsequent morbidity. Anatomical consideration, etiology, correlation between sexual dysfunction and genitourinary lesions, or pelvic fracture type were investigated. Conclusion There are evidences in the literature that the gravity and frequency of SD are related with the pelvic ring fracture type. In fact, patients with APC, VS (according Young-Burgess), or C (according Tile) fracture pattern reported higher incidence and gravity of SD. Only a week association could be found between GUI and incidence and gravity of SD, and relationship between surgical treatment and SD. Electrophysiological tests should be routinely used in patient suffering from SD after pelvic ring injuries.

Sign in / Sign up

Export Citation Format

Share Document