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Gabapentin And Erectile Dysfunction

gabapentin and erectile dysfunction

Description

Low-dose gabapentin may result in marked sexual dysfunction, including loss of libido, erectile dysfunction, ejaculatory dysfunction, and anorgasmia. Such sexual dysfunction may lead to medication noncompliance.

Psychotropics and sexual dysfunction

Libido is primarily a function of hormonal and CNS control. By contrast, erectile functions are mediated through local parasympathetic stimulation and ejaculation, which are controlled by norepinephrine. Orgasm is a cerebral cortical event distinct from ejaculation; either process can be disturbed independently. Elevated central serotonin levels inhibit orgasm and, to a lesser extent, ejaculation. Dopamine elevation over time leads to hyperprolactinemia and resultant hypotestosteronemia, decreasing libido.

Common Medications Can Cause Erectile Dysfunction

1. Beta-blockers

“No question these impact erectile function,” says Landon Trost, MD, head of andrology and male infertility at the Mayo Clinic in Rochester, Minn. It is not clear why these blood pressure lowering medications can cause ED, but it reverses if a patient quits taking the drug. Unfortunately, however, “people usually can’t get off of these, but if the medication can be switched for another blood pressure drug, angiotensin receptor blockers or ACE nhibitors are preferred,” adds Trost.

2. Androgen blockers

Often prescribed to treat prostate cancer, these medications can cause ED and decreased libido along with many other side effects. “It typically takes several months to years to see the full impact of these medicines, and often they cannot be discontinued,” says Trost, unless they were prescribed for recurrent long-lasting erections — a condition called priapism — in the first place. In that case, your doctor may be able to prescribe an alternative medication.

Conclusions:

Sexual dysfunction is a key adverse effect leading to medication noncompliance. Psychotropic drugs associated with sexual dysfunction include antiepileptic drugs, antidepressants, and antipsychotics. Gabapentin, frequently used off-label to treat psychiatric and pain disorders, has previously been reported to cause sexual dysfunction at a minimum total daily dose of 900 mg. This report addresses dose-dependent gabapentin-induced sexual dysfunction reaching total sexual dysfunction (loss of libido, anejaculation, anorgasmia, and impotence) at a total daily dose of only 300 mg.

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