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Gabapentin Erectile Dysfunction

gabapentin erectile dysfunction

Gabapentin-induced sexual dysfunction

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.

Common Medications Can Cause Erectile Dysfunction

Erectile dysfunction. We’ve all heard of it. And Pfizer’s advertising campaign when it introduced its blockbuster ED drug Viagra (sildenafil) made it a household phrase. Up to 30 million men in the US have trouble getting or maintaining an erection sufficient for sexual intercourse, according to recent estimates. It can affect men of all races and ages, though rates are moderately higher among men aged 70 and older, compared to men in younger age groups.

Contrary to popular belief, however, aging does not cause ED. A wide range of physical and psychological conditions can lead to ED, including high blood pressure, heart disease, diabetes, anxiety, depression and lifestyle factors such as alcohol and illicit drug use and smoking.

Another common cause of ED is prescription medication, and 5 drugs in particular have the biggest effect on libido.

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.

3. Finasteride

This medication is sold under the brand names Propecia and Proscar and is used to treat male hair loss. It “diminishes dihydrotestosterone levels and suppresses libido in about 10 percent of men but is much more profound in younger guys,” according to Jesse N. Mills, MD, an associate professor of urology at the David Geffen School of Medicine at the University of California, Los Angeles, and director of The Men’s Clinic at UCLA. “Try stopping and using minoxidil instead for hair preservation,” if you have ED that is caused by this drug, he advises.

4. Sedatives and anxiolytics

“Anything that depresses nerves, such as Xanax, Ativan, Valium, alcohol, Neurontin (gabapentin), Lyrica (pregabalin), and any of the sleep aids often impact erectile function,” says Trost. The effect is reversible and is most likely caused by direct suppression of nerve signals or possibly by changes in hormonal signaling. Mills adds that “narcotic use causes suppression of testosterone which can alter blood flow to the penis.”

5. Antidepressants

These commonly prescribed medications affect sexual function in different ways depending on the specific type of drug and how it works. “Central regulation of erections relies on dopamine and serotonin, so any impact on these processes can worsen erectile function,” says Trost. He notes that Wellbutrin (buproprion) and Remeron (mirtazipine) are the antidepressants that likely have the least impact on erectile function.

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