scholarly journals Lithium and Erectile Dysfunction: An Overview

Cells ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 171
Author(s):  
Mohammad Sheibani ◽  
Mehdi Ghasemi ◽  
Ahmad Reza Dehpour
Keyword(s):  
Adverse Effect ◽  
Erectile Dysfunction ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Clinical Studies ◽  
Bipolar Disorders ◽  
Preclinical Studies ◽  
Medication Intake

Lithium has been a mainstay of therapy for patients with bipolar disorders for several decades. However, it may exert a variety of adverse effects that can affect patients’ compliance. Sexual and erectile dysfunction has been reported in several studies by patients who take lithium as monotherapy or combined with other psychotherapeutic agents. The exact mechanisms underlying such side effects of lithium are not completely understood. It seems that both central and peripheral mechanisms are involved in the lithium-related sexual dysfunction. Here, we had an overview of the epidemiology of lithium-related sexual and erectile dysfunction in previous clinical studies as well as possible pathologic pathways that could be involved in this adverse effect of lithium based on the previous preclinical studies. Understanding such mechanisms could potentially open a new avenue for therapies that can overcome lithium-related sexual dysfunction and improve patients’ adherence to the medication intake.

Sexual dysfunction and mood stabilizers in bipolar disorder: A review

2017 ◽  
Vol 41 (S1) ◽  
pp. s849-s849 ◽  
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.

A Rare Case of Drug-Induced Erectile Dysfunction with Secukinumab Solved After Switch to Ixekizumab in A Psoriatic Patient: A Case Report

2020 ◽  
Vol 15 (1) ◽  
pp. 69-72
Author(s):  
Stefano Dastoli ◽  
Luigi Francesco Iannone ◽  
Luigi Bennardo ◽  
Martina Silvestri ◽  
Caterina Palleria ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Erectile Dysfunction ◽  
Sexual Dysfunction ◽  
Rare Case ◽  
Interleukin 17 ◽  
Inflammatory Condition ◽  
Biologic Drugs ◽  
Drug Induced ◽  
First Case ◽  
First Time

Background: Psoriasis is a cutaneous inflammatory condition characterized by an altered turnover of keratinocytes leading to scaly patches. Secukinumab and ixekizumab are two biologic drugs inhibiting interleukin-17. Objective: We report the first case, according to Naranjo score, of a secukinumab-induced erectile dysfunction with severe plaque psoriasis that disappeared after switching to another anti IL17 drug (ixekizumab). Methods: A 45 years old man experienced erectile dysfunction during treatment with an anti-IL17. The adverse effect appeared after 60 days of treatment with secukinumab and rapidly disappeared after discontinuation of the drug. All necessary urologic exams were carried out. Re-administration of secukinumab, due to the exacerbation of psoriasis, caused the same sexual dysfunction after 60 days. Results: Switching to ixekizumab lead to a resolution of the erectile dysfunction and a complete skin clearance. Conclusion: We describe for the first time a sexual dysfunction possibly due to secukinumab and its resolution after the switch to another similar but different drug, highlighting the potential difference between anti-IL17A drugs.

Female Sexual Side Effects Associated with Selective Serotonin Reuptake Inhibitors: A Descriptive Clinical Study of 33 Patients

1995 ◽  
Vol 25 (3) ◽  
pp. 239-248 ◽  
Author(s):  
Winston W. Shen ◽  
Jeffrey H. Hsu
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Serotonin Reuptake ◽  
Female Sexual Dysfunction ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Spontaneous Remission ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Sexual Side Effects

Objective: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects. Methods: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects. Results: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described. Conclusions: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.

scholarly journals Weight Gain and Hair Loss during Anti-TNF Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Abdo Lutf ◽  
Mohammed Hammoudeh
Keyword(s):  
Adverse Effect ◽  
Weight Gain ◽  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Side Effects ◽  
Adverse Effects ◽  
Hair Loss ◽  
Rheumatology Clinic ◽  
Relationship Of ◽  
The Relationship

Objectives. To investigate the incidence of weight gain and hair loss as adverse effects of anti-TNF therapy in rheumatic diseases.Methods. Patients using anti-TNF therapy, who are followed in rheumatology clinic, were interviewed using a questionnaire to investigate the side effects of anti-TNF therapy. Patients who complained of hair loss and weight gain were asked additional questions concerning the relationship of these adverse effects to anti-TNF use, whether therapy was stopped because of these adverse effects and if the adverse effects reversed after stopping therapy. The files were reviewed to follow the weight change before, during, and after discontinuation of anti-TNF.Results. One hundred fifty consecutive patients (82 RA, 34 ankylosing spondylitis, 32 psoriatic arthritis, and 4 for other indications) were interviewed .Weight gain was observed in 20 patients (13.3%) with average gain of 5.5 Kg. Anti-TNF was stopped in five patients because of this adverse effect. Hair loss during anti-TNf therapy was reported in five females (3.3%) and anti-TNF therapy was stopped in all of them.Conclusion. Weight gain and hair loss appear to be associated with anti-TNF therapy and may be one reason for discontinuing the therapy.

Sexual Dysfunction in Patients on Antipsychotic Therapy Vladica Sibinovic Psychiatry Clinic CC NIS

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Sibinovic
Keyword(s):  
Erectile Dysfunction ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Sexual Experience ◽  
Typical Antipsychotic ◽  
Antipsychotic Therapy ◽  
Icd 10 ◽  
Ejaculatory Dysfunction

The aim of this study was to determine difference in sexual dysfunction between 137 stabilized male outpatients who met ICD-10 criteria for acute and transient psychotic disorders (F 23) and schizophrenia (F 20) under therapy atypical and typical antipsychotic.Arizona Sexual Experience Scale (ASEX) and the subscale on sexual function of the UKU Side Effects Rating Scale were applied at a single interview.Sexual dysfunction was observed in 55, 47% (76 patients). We find higher ASEX and UKU score in patient with schizophrenia under therapy atypical and typical antipsychotic (p=0, 01). in patients with schizophrenia under typical antipsychotic, orgastic dysfunction (p< 0, 05) is more common.Ejaculatory dysfunction and erectile dysfunction are also high in that group (p< 0, 05).Therapies with atypical and typical antipsychotic have the same effects on increased or diminished sexual desire in bout group of patients.In patients with schizophrenia under typical antipsychotic there is higher ASEX score then in patients under atypical antipsychotic (p< 0, 05). Patients with acute and transient psychotic disorders do not have difference on level of sexual dysfunction in correlation with treated by atypical and typical antipsychotic.Results show that sexual dysfunction is more common in patients with schizophrenia under therapy with typical antipsychotic. in group of patients with acute and transient psychotic disorders there is no difference betven therapy atypical or typical antipsychotic in sexual dysfunction.

scholarly journals Analgesic Efficacy and Adverse Effects of Meperidine in Managing Postoperative or Labor Pain: A Narrative Review of Randomized Controlled Trials

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 175-201
Author(s):  
Chi Wai Cheung
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Randomized Controlled Trials ◽  
Safety Profile ◽  
Clinical Studies ◽  
Analgesic Efficacy ◽  
Labor Pain ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled

Background: Meperidine, a synthetic opioid, has a rapid onset and short duration of action. Mounting evidence has challenged meperidine’s analgesic benefits, and concerns have been raised about its safety profile. Despite recommendations to restrict the prescription of meperidine, the drug remains frequently used. Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety of meperidine for acute postoperative and labor pain. Study Design: This was a narrative review of the analgesic efficacy and side effects of meperidine compared to other analgesic drugs for acute postoperative and labor pain in adults. Setting: Randomized controlled trials that compared the analgesic efficacy and side effect profile of meperidine versus another analgesic drug in adult patients were evaluated. Methods: A systemized search of randomized controlled trials studying meperidine for acute postoperative or labor pain in the adult patient population from PubMed, Medline, and EMBASE was performed. Included studies reported on different routes of meperidine administration including intramuscular, intravenous, and patient-controlled analgesia in various surgical procedures such as abdominal surgery, Cesarean section, gynecological surgery, orthopedic surgery, cardiothoracic surgery, as well as for labor analgesia. Meperidine’s analgesic efficacy and safety profile were compared to other opioids (morphine, tramadol, fentanyl, buprenorphine, nalbuphine, and pentazocine), nonsteroidal anti-inflammatory drugs (ketorolac, diclofenac, and indomethacin), dipyrone, ketamine, and bupivacaine. Results: A total of 62 randomized controlled trials published between 1972 and 2018 were reviewed. Meperidine had a similar or inferior analgesic efficacy compared to other analgesics for acute postoperative or labor pain. Meperidine was associated with more sedation and respiratory depression. Limitations: The sample sizes of many clinical studies were small, and therefore probably insufficiently powered to detect differences in uncommon side effects, such as central nervous system toxicity. In addition, some of the included clinical studies were old. Conclusion: Considering the availability of other effective analgesics with potentially fewer side effects, the use of meperidine for acute postoperative or labor pain should not be recommended. Key words: Acute postoperative pain, adverse effects, labor analgesia, meperidine, pethidine

scholarly journals An audit assessing the monitoring of SSRIS after initiation in children and adolescents

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S41-S41
Author(s):  
Ella McGowan
Keyword(s):  
Adverse Effect ◽  
Side Effects ◽  
Adverse Effects ◽  
Children And Adolescents ◽  
Alternative Plan ◽  
Medication Dose ◽  
The Common ◽  
The One ◽  
Accurate Record

AimsTo identify children and adolescents started on SSRIs to see if they are being followed up in accordance to NICE and Maudsley guidelinesObjectivesHas the patient been followed up after a week to check for adverse effects or improvement in their mental state?Has the patient been re-evaluated every 4-6 weeks, if not is there an alternative plan?If there is no improvement has the dose been increased?If there is an adverse effect has the dose been lowered or the medication stopped?MethodPaper case notes including clinic letters and handwritten notes were reviewed on the 19/10/2020. The following data were collected anonymously.AgeGenderDate seen / Date medication startedName of medicationDate medication startedDate of Follow-upMonitoring of improvementMonitoring of adverse effectsOutcome of monitoringResultA total of 18 sets of cases were identified.Follow-up occurred in 17 of the 18 cases.The one case that had not been followed up had started the medication 8 weeks before the audit. The median follow-up time was 42 days (6 weeks). No cases were followed up within a week.Monitoring of improvement was recorded in 88% of case notes reviewed.Monitoring for adverse effects occurred in 36% of case notes and none of these patients had reported any side effects. 53% of cases did not have monitoring of adverse effects documented. There were two patients (11%) who did not take the medication as prescribed. One out of choice and one their parent had not collected it.The medication dose was increased in 22% of patients without clear documentation of monitoring for adverse effects.ConclusionAfter discussion with the clinical lead it was decided it is impractical to follow up patients a week after starting medication. However, patients and their carers should be informed of the side effects and advised to contact CAMHS if adverse effects occur.The area of practice that can be improved is the documentation of adverse effects at follow-up.Recommendations:All patients to be informed of the common side effects of the medication before it is initiated and advised to contact the CAMHS team if they have concernsAll CAMHS patients started on SSRIs should be followed up within 4-6 weeksAt follow-up any adverse events and clinical response should be discussedAn accurate record of the exchanges of the above information should be documented in the notesRe-audit

scholarly journals Adverse Events Profile of Low-dose Methotrexate in Nepalese Patients with Rheumatoid Arthritis: an Observational Study

2020 ◽  
Vol 18 (3) ◽  
pp. 360-365
Author(s):  
Shweta Nakarmi ◽  
Kalpana Pudasaini ◽  
Bhojraj Adhikari ◽  
Binit Vaidya
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effect ◽  
Side Effects ◽  
Liver Function ◽  
Adverse Effects ◽  
Adverse Events ◽  
Observational Study ◽  
P Value ◽  
Function Tests ◽  
Patient Reported

Background: Methotrexate is considered as the anchor drug for the treatment of rheumatoid arthritis. However, various adverse effects limit its use leading to frequent discontinuation of treatment. This study aimed to evaluate the common adverse effects of methotrexate in patients with rheumatoid arthritis. Methods: A prospective observational study was conducted at National Center for Rheumatic Diseases from June 2018 to May 2019 among patients with rheumatoid arthritis using methotrexate monotherapy. Laboratory tests like liver function tests, renal function tests, complete blood count, C-reactive protein, erythrocyte sedimentation rate were done at baseline and every 3 months. Data on patients’ comorbidities, disease activity and side effects of drug were collected on every follow- up. Statistical analysis was carried out with the help of SPSS 23.0. Results: Out of 232 patients experiencing at least one adverse effect while on methotrexate monotherapy, 87.5% were female and mean age was 46.9±10.8 years. The mean dose of methotrexate was 16.6 ± 3.9 mg/week with the most frequently used dose of 20mg/week. Among the variety of adverse reaction observed, the most common was transaminitis (75.0%) with approximately 50.0% as isolated liver function abnormality, followed by nausea (19.4%), anorexia (12.9%), leukopenia (12.5%), oral ulcer (8.2%) and psychological intolerance (4.7%). Multiple regression analysis showed significant predictive value of body mass index for transaminitis (p-value 0.007). Conclusions: Asymptomatic liver function test derangement was the most frequent adverse-effect of methotrexate observed, whereas nausea and anorexia were the most common patient reported events. The frequent dose associated with side-effects in Nepalese patients was around 20mg/week. Keywords: Adverse events; methotrexate; Nepal; rheumatoid arthritis

Finasteride, not tamsulosin, increases severity of erectile dysfunction and decreases testosterone levels in men with benign prostatic hyperplasia

2015 ◽  
Vol 23 (3) ◽  
Author(s):  
Abdulmaged M. Traish ◽  
Karim Sultan Haider ◽  
Gheorghe Doros ◽  
Ahmad Haider
Keyword(s):  
Erectile Dysfunction ◽  
Benign Prostatic Hyperplasia ◽  
Side Effects ◽  
Adverse Effects ◽  
Erectile Function ◽  
Prostatic Hyperplasia ◽  
Continuous Treatment ◽  
Plasma Testosterone ◽  
The Impact

Abstract5α-reductase inhibitors (5α-RIs) (finasteride and dutasteride) have been proven useful in treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). However, these inhibitors exert undesirable sexual side effects and, in some cases, these effects are persistent. There is considerable disagreement with regard to whether the adverse side effects resolve with continuous treatment.To investigate the long-term adverse effects of finasteride treatment in men with BPH on erectile function and to compare these adverse effects in men treated with the α1-adrenergic receptor blocker, tamsolusin.In this retrospective registry study, a cohort of 470 men aged between 47 and 68 years (mean 57.78±4.81) were treated with finasteride (5 mg/day). A second cohort of 230 men aged between 52 and 72 years (mean 62.62±4.65) were treated with tamsulosin (0.4 mg). All men were followed up for 45 months. At intervals of 3 months and at each visit, plasma testosterone (T) levels and the international index of erectile function (IIEF-EF) questionnaire scores were determined.Long-term treatment with finasteride therapy is associated with worsening of erectile dysfunction (ED) as shown by the significant decrease in the IIEF-EF scores in men treated with finasteride. No worsening of ED was observed in men treated with tamsulosin. The increase in ED due to finasteride did not resolve with continued treatment with finasteride. Most importantly, long-term finasteride therapy resulted in reduction in total T levels, contributing to a state of hypogonadism. On the contrary, no changes in T levels were noted in men treated with tamsolusin.Our findings suggest that in men with BPH, long-term finasteride therapy but not tamsulosin results in worsening of ED and reduces total T concentrations. Clinicians are urged to discuss the impact of 5α-RIs therapy on sexual function with their patients before commencing this therapy.

scholarly journals Is Vortioxetine an Advantageous Choice for Erectile Dysfunction? A Case Report

2020 ◽  
Vol 2 (3-4) ◽  
pp. 281-283
Author(s):  
Roshan Sutar ◽  
Faisal Siddiqui ◽  
Abin Rajan
Keyword(s):  
Major Depressive Disorder ◽  
Erectile Dysfunction ◽  
Case Report ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Depressive Disorder ◽  
Sexual Functioning ◽  
Major Depressive ◽  
Clinical Dilemma ◽  
The Right

Commonly prescribed antidepressants are associated with sexual adverse effects predominantly reported as erectile dysfunction by men. The clinical dilemma of choosing the right antidepressant while not compromising the sexual functioning is an area of recent research. Few antidepressants, namely dapoxetine, bupropion, trazodone, and mirtazapine, have been reported to have minimal sexual adverse effects. Vortioxetine is a relatively newer antidepressant with clinical profile having minimal sexual and cognitive adverse effects. However, improvement in sexual dysfunction after treatment with vortioxetine has not been reported so far. We highlight the unique benefit of vortioxetine in improving sexual dysfunction in a case of major depressive disorder.

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