Advertisement

 

 

Co-Morbid Erectile Dysfunction (Ed) and Antidepressant Treatment in a Patient – A Management Challenge?

Co-Morbid Erectile Dysfunction (Ed) and Antidepressant Treatment in a Patient – A Management Challenge?
Author Information (click to view)

Zainol M, Sidi H, Kumar J, Das S, Ismail S, Hatta MH, Baharudin N, Ravindran A,


Zainol M, Sidi H, Kumar J, Das S, Ismail S, Hatta MH, Baharudin N, Ravindran A, (click to view)

Zainol M, Sidi H, Kumar J, Das S, Ismail S, Hatta MH, Baharudin N, Ravindran A,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Current drug targets 2017 03 15() doi 10.2174/1389450118666170315110902
Abstract

Across the globe, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are commonly prescribed psychopharmacological agents for patients with co-morbid mental-health problem and sexual dysfunction (SD). The serotonergic and/or noradrenergic ADs, although is an effective agent are not without SD side-effects, especially erectile dysfunction (ED). ED is an inability to achieve, or maintain an erection for satisfactory sexual intercourse during the phases of male’s sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who are on AD. AD intervention caused remission to some of the pre-treatment psychopathology of ED, but to many patients, AD potentially magnified the unwanted sexual side-effects. This made this situation a challenging task for the mental health professional. These challenges are based on the complexity of ED – its etiology, and the associated risk factors, which further compounded with AD side-effect. The neuro-psychopharmacological basis for AD treatment selection used was deliberated. Biopsychosocial interventions are recommended at a two pivotal stage. First, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identifying some modifiable risk factors for ED and associated mental health issue. Secondly, with guidance of an algorithm pathway, a practical intervention should include steps like dose reduction, augmentation or changing to an AD with lesser/ no sexual side-effects like bupropion and mirtazepine. Some achievable suggestions, e.g. revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other non-pharmacological approaches will be beneficial for both patients and his partner.

Submit a Comment

Your email address will not be published. Required fields are marked *

twenty − eight =

[ HIDE/SHOW ]