Erectile Dysfunction in Vietnam Vets

Most people think that veterans who come home after the war can now live in peace.  However, for most veterans who have to contend with illnesses both psychological and physical, the war is no yet over.

Most illnesses faced by war veterans are easily diagnosed such as paralysis, broken limbs and legs.  However, there are illnesses that are not easily diagnosed such as erectile dysfunction. They may be tough in war but most veterans do not even have the courage to tell their doctors about their failure to achieve an erection.

Thanks to the popularity of erectile dysfunction drugs like Viagra, Levitra and Cialis patients who are suffering from the symptoms of erectile dysfunction are now more open to discussing their conditions with their doctors.  Erectile dysfunction can occur for several reasons in veterans and the most common are, physical or psychological .

A war veteran can also suffer from erectile dysfunction for other reasons including nerve damage or exposure to Agent Orange. It can also result from Diabetes, from the intake of medications or from psychological causes like stress and depression.  Among the most traditional options for those with erectile dysfunction include surgery and implantation of medical devices to encourage erection.  Aside from the pain involved in the traditional methods the strange-looking medical devices are enough to stop any man from having an erection much less encourage the couple to enjoy the sexual act.

Thanks to Cialis and other erectile dysfunction medications even the most macho of men including veterans have been encouraged to speak more openly about erectile dysfunction with their doctors.

The Australian government made the first step when it made Viagra available for free to veterans who have been diagnosed with impotence or erectile dysfunction problems related to war. Impotence resulting from war-related causes is now an accepted military disability and war veterans in Australia can expect support from the government.

Under the said government program, the veterans have to pay about $3.30 instead of $80 for a box of Viagra containing four pills, but it is not clear if this same program is available for the other 2 treatments Cialis and Levitra . However, proper medical diagnosis should be taken before they can avail of the program to avoid the possibility of Viagra’s interaction with hypertension and heart diseases.

Taking migraine medications and antidepressants at the same time

Research suggests that combining migraine medications called triptans with certain antidepressants — including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) — may increase the risk of a rare but serious condition called serotonin syndrome. Although the risk appears to be quite low, debate continues about the level of risk.

Serotonin syndrome occurs when your body has too much serotonin — a chemical found in your nervous system. Triptans, SSRIs and SNRIs naturally raise serotonin levels on their own. When these medications are taken together, the effect may be more pronounced.

Signs and symptoms of serotonin syndrome occur quickly — within minutes to hours — and may include:

• Nausea, vomiting and diarrhea
• Fever
• Increased heart rate (tachycardia)
• Changes in blood pressure
• Overactive reflexes (hyperreflexia)
• Extreme agitation or restlessness
• Hallucinations
• Loss of coordination
• Seizures
• Coma

With prompt treatment — including stopping any medications that may be increasing your serotonin level — signs and symptoms of serotonin syndrome usually stop within 24 hours. Left untreated, serotonin syndrome may be fatal.

Less seriously, there may be a risk of interactions between other antidepressants and migraine medications. A class of antidepressants known as monoamine oxidase inhibitors (MAOIs) can affect how triptans work — increasing the level of triptans in your blood. And SSRIs and MAOIs should be used sparingly with migraine medications called ergotamines, since these antidepressants can slow down the speed at which ergotamines break down.

If you're taking migraine medications and antidepressants, talk to your doctor — especially if you notice any changes in your health. Don't stop or change the dosages of any of your medications on your own. If you experience signs or symptoms of serotonin syndrome, seek immediate medical attention.

Antidepressants and Sexual dysfunction

Sexual functioning can be affected by many things. Some of these factors include: past sexual experiences, religious beliefs, upbringing, self-esteem, medications (both psychiatric and non-psychiatric, such as some blood pressure medications), depression, and medical conditions such as diabetes or sleep apnea. There may be alternative medications you can use. This is by no means an exhaustive list, so talk with your doctor.

People can have difficulty with one or more of the phases of sexual functioning: desire, arousal and orgasm. Libido, or sex drive, may be reduced during a depressive episode. People describe not having interest in sex and in addition may not be able to have an orgasm. In order to achieve orgasm, arousal must occur. Some people can have low sex drive but are still able to become aroused and achieve orgasm.

A study just published this month in the "Journal of the American Medical Association" (JAMA) claims successful treatment of arousal and orgasm. This study was done on women only.

The study, an 8 week trial, included 98 women currently taking a serotonin reuptake inhibitor (SRI) anti-depressant medication. One-half took Viagra and the other half took a placebo. It showed that Viagra improved orgasm delay but not sexual desire, so will not help everyone. Viagra does have side effects, some of which can be very serious. No study is without bias. The number of women included is not a large number, so it is difficult to apply the results to the general population.

Also, the women's depression had to be in remission to be included in the study. So, was their sexual functioning improved because their depression was treated or was it because of the Viagra? Viagra needs to be taken one hour before sexual activity, so some feel that it reduces spontaneity.

As always, talk with your doctor about options if you have sexual dysfunction. Wellbutrin has a low incidence of sexual dysfunction as does Remeron. These both have potential side effects with Wellbutrin sometimes worsening anxiety and Remeron causing weight gain. Some people have sexual dysfunction with antidepressants such as Prozac, Paxil, Effexor, Cymbalta, Zoloft or Celexa, and some do not. We cannot predict who will have what side effect and to what degree at this time. We are learning more all the time, so stay tuned!