Overall level of evidence of adverse effects C

Compound

Cocaine (N01BC01)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Dose arms 1-3 Study quality Reference

Cocaine addiction Hormones

All ages Single dose 0.4 mg/kg

Hormone levels, alteration

LH levels increase, T levels unchanged, prolactin levels decrease

Cocaine; nicotine 21323: Mendelson JH, Sholar MB, Mutschler NH, Jaszyna-Gasior M, Goletiani NV, Siegel AJ, Mello NK. Effects of intravenous cocaine and cigarette smoking on luteinizing hormone, testosterone, and prolactin in men. J Pharmacol Exp Ther. 2003 Oct;307(1):339-48. English

570

2 Drugs Which Compromise Male Sexual Health

Compound

Cocaine (N01BC01)

Disease treated

Cocaine addiction

Quantification

Hormones

of adverse effects

No. of patients treated

16

Age group

All ages

Treatment period

4 weeks after cessation

Dose

Various

Treatment

Hormone levels, alteration

consequences

Efficacy

Prolactin levels increase, LH and T unchanged

Randomization

No

of patients

Study quality

3

Reference

1326: Mendelson JH, Teoh SK, Lange U, Mello NK, Weiss R, Skupny A, Ellingboe J. Anterior pituitary, adrenal, and gonadal hormones during cocaine withdrawal. Am J Psychiatry. 1988 Sep;145(9):1094-8.

Language

English

Compound

Cocaine (N01BC01)

Disease treated

Cocaine addiction

Quantification

Hormones

of adverse effects

No. of patients treated

12

Age group

All ages

Treatment period

Single dose

Dose

2 mg intranasally

Treatment

Hormone levels, alteration

consequences

Efficacy

LH levels increase, T levels unchanged, prolactin levels decrease

Randomization

Yes

of patients

Dose arms 1-3

Cocaine; placebo

Study quality

1-

Reference

1324: Heesch CM, Negus BH, Bost JE, Keffer JH, Snyder RW 2nd, Eichhorn EJ. Effects of cocaine on anterior pituitary and gonadal hormones. J Pharmacol Exp Ther. 1996 Sep;278(3):1195-200.

Language

Cocaine (N01BC01)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Study quality Reference

Language

Cocaine addiction Hormones

All ages

Continuous

Various

Hormone levels, alteration

LH peaks increase No

1325: Mendelson JH, Mello NK, Teoh SK, Ellingboe J, Cochin J. Cocaine effects on pulsatile secretion of anterior pituitary, gonadal, and adrenal hormones. J Clin Endocrinol Metab. 1989 Dec;69(6):1256-60. English

N02

Analgesics

There are few reports on limited adverse effects of analgesics on erectile function. Ergotamine induced relaxation of cavernosal smooth muscles, but clinical studies are not available.

Overall level of evidence of adverse effects: C

Compound

Buprenorphine (N02AE01)

Disease treated

Opiate addiction

Quantification of adverse effects

Sexual function scale; hormones

No. of patients treated

105

Age group

Young

Treatment period

Continuous

Dose

Various

Treatment

Sexual function, impairment; testosterone level, increased

consequences

Efficacy

Significantly higher in buprenorphine group than in methadone group

Randomization of patients Dose arms 1-3 Study quality Reference

Language

Methadone; buprenorphine; healthy blood donors 21398: Bliesener N, Albrecht S, Schwager A, Weckbecker K, Lichtermann D, Klingmuller D. Plasma testosterone and sexual function in men receiving buprenorphine maintenance for opioid dependence. J Clin Endocrinol Metab. 2005 Jan;90(1):203-6. Epub 2004 Oct 13. English

Compound Dihydergotamine (N02CA01)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Study quality Reference

Language

Erectile dysfunction Erectile function n.g. Old

On demand 5 mg

Erectile function, duplex sonography, improvement

In non-responders to sildenafil No

1625: Dunzendorfer U, Behm A, Dunzendorfer E, Dunzendorfer A. Drug combinations in the therapy of low response to phosphodiesterase 5 inhibitors in patients with erectile dysfunction. In Vivo. 2002 Sep-Oct;16(5):345-8. English

Compound Ergotamine (N02CA02)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Cavernous tissue in vitro Muscle relaxation

42-68 years In vitro 5x10-4g

Cavernous tissue, relaxation

2.4 Drugs Which Compromise Erectile Function 573

Efficacy

Poor

Study quality

2-

Reference

1438: Barbanti G, Beneforti P, Lapini A, Turini D. Relaxation

of isolated corpus cavernosum induced by smooth-

muscle relaxant drugs. A comparative study. Urol Res.

1988;16(4):299-302.

Language

English

N03

Antiepileptics

This class of drugs generally impairs sexual function, in

particular erectile function, although no depression, but

even an increase of testosterone levels, was observed;

however, also untreated patients with epilepsy suffer from

impaired sexual functions, so the attribution to antiepilep-

tics is questionable.

Overall level of evidence of adverse effects: C

Compound

Antiepileptics (N03A)

Disease treated

Epilepsy

Quantification

Sexual function scale; hormones

of adverse effects

No. of patients treated

85

Age group

Young

Treatment period

6 months

Dose

Various

Treatment

Sexual function, impairment; testosterone level, increased

consequences

Efficacy

Various

Randomization

No

of patients

Dose arms 1-3

Carbamazepine; phenytoin; untreated epilepsy

Study quality

2-

Reference

1364: Herzog AG, Drislane FW, Schomer DL, Pennell PB,

Bromfield EB, Dworetzky BA, Farina EL, Frye CA. Differential

effects of antiepileptic drugs on sexual function and

hormones in men with epilepsy. Neurology. 2005 Oct

11;65(7):1016-20.

Language

English

574

2 Drugs Which Compromise Male Sexual Health

Compound

Antiepileptics (N03A)

Disease treated

Epilepsy

Quantification

Erectile function

of adverse effects

Age group

Young

Treatment

Erectile function, impairment

consequences

Efficacy

Dependent on medication

Study quality

4 (review)

Reference

1357: Mattson RH, Cramer JA. Epilepsy, sex hormones, and

antiepileptic drugs. Epilepsia. 1985;26 Suppl 1 :S40-51.

Language

English

Compound

Antiepileptics (N03A)

Disease treated

Epilepsy

Quantification

Hormones

of adverse effects

No. of patients treated

54

Treatment period

No treatment

Age group

Young

Treatment

Sexual activity decreased; LH, FSH, prolactin, and sex-

consequences

hormone binding globulin (SHBG) levels increased

Efficacy

Significant

Study quality

2-

Reference

1412: Toone BK, Wheeler M, Fenwick PB. Sex hormone

changes in male epileptics. Clin Endocrinol (Oxf). 1980

Apr;12(4):391-5.

Language

English

Compound

Antiepileptics (N03A)

Disease treated

Epilepsy

Quantification

Hormones

of adverse effects

No. of patients treated

20

Age group

Young

Treatment period

No treatment

Treatment

Sexual libido decrease, gonadotropin levels decreased

consequences

Efficacy

11 of 20 patients

Study quality

Language

1410: Herzog AG, Seibel MM, Schomer DL, Vaitukaitis JL, Geschwind N. Reproductive endocrine disorders in men with partial seizures of temporal lobe origin. Arch Neurol. 1986 Apr;43(4):347-50. English

Compound

Antiepileptics (N03A)

Disease treated Quantification of adverse effects Age group Treatment period Treatment consequences Efficacy Remarks

Study quality Reference

Language

Epilepsy Sexual function

All ages

No treatment

Sexual functions, impaired

Epileptic discharges in limbic structures may contribute to sexual dysfunction. 4 (review)

1355: Morrell MJ. Sexual dysfunction in epilepsy. Epilepsia.

1991 ;32 Suppl 6:S38-45.

English

Compound

Phenytoin (N03AB02)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Study quality Reference

Epilepsy

Sexual function scale; hormones

152 Young Continuous Various

Sexual function, impairment; testosterone level increased, SHBG level increased, DHEA level unaltered Significant No

1371: Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999 Feb;40(2):197-204. English

576

2 Drugs Which Compromise Male Sexual Health

Compound

Clonazepam (N03AE01)

Disease treated

Post-traumatic stress disorder (PTSD)

Quantification

Sexual function questionnaire

of adverse effects

No. of patients treated

100

Age group

Middle-aged

Treatment period

Continuous

Dose

3.4 mg/day

Treatment

Sexual dysfunction

consequences

Efficacy

43% of patients

Randomization

No

of patients

Study quality

3

Reference

1624: Fossey MD, Hamner MB. Clonazepam-related sexual dysfunction in male veterans with PTSD. Anxiety. 1994-95;1 (5):233-6.

Language

English

Compound

Carbamazepine (N03AF01 )

Disease treated

Epilepsy

Quantification

Sexual function scale; hormones

of adverse effects

No. of patients treated

184

Age group

18-65 years

Treatment period

Continuous

Dose

Various

Treatment

Sexual function, depressed; testosterone level unaltered,

consequences

SHBG level increase, DHEA level decreased

Efficacy

Men receiving antiepileptic drugs embraced a stricter sexual morality than the controls and untreated, and expressed greater satisfaction with their marriages than the control and untreated groups.

Randomization

No

of patients

Study quality

3

Reference

1371: Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999 Feb;40(2):197-204.

Language

Valproate (N03AG01)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Study quality Reference

Language

Epilepsy

Sexual function scale; hormones

152 Young Continuous Various

Sexual function, depressed; testosterone level unaltered, SHBG level unaltered, DHEA level unaltered On average No

1371: Duncan S, Blacklaw J, Beastall GH, Brodie MJ. Antiepileptic drug therapy and sexual function in men with epilepsy. Epilepsia. 1999 Feb;40(2):197-204. English

Compound

Lamotrigine (N03AX09)

Disease treated Quantification of adverse effects No. of patients treated Age group Treatment period Dose

Treatment consequences

Efficacy

Randomization of patients Study quality Reference

Epilepsy Erectile function

Young 8 months Various

Sexual function, improvement

After cessation of other antileptics No

1592: Husain AM, Carwile ST, Miller PP, Radtke RA. Improved sexual function in three men taking lamotrigine for epilepsy. South Med J. 2000 Mar;93(3):335-6. English

Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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