John C. Buffum

Pharmacosexology: the effects of drugs on sexual function a review.

The literature on the sexual side effects of drugs and chemicals has been reviewed. There are many substances which alter the human sociosexual response cycle either negatively, positively or both. Many of the drugs used therapeutically have been reported to have adverse effects on sexuality, and this must be taken into account when these drugs are used clinically. Many substances which are used for recreational purposes (or sometimes abused) also have profound effects on sexual response. Many of these substances are used in such a way that they can correct underlying sexual problems. Treatment of a drug abuser may well prove unsuccessful without consideration of preexistent sociosexual problems and concerns. From the dawn of recorded history, many substances have been used for the purpose of sexual enhancement. Some of these have known success and their reputations have been passed down through the millenia. The chapter has not yet been closed on aphrodisiacs, even though none have survived the rigors of scientific scrutiny. As long as humans place value on optimal sexual functioning, there will be a demand for sex-enhancing drugs. In order for the scientific and medical community to successfully meet these challenges, more effective and relevant study designs will have to be utilized in order to separate fact from fancy. The study of pharmacosexology is in its infancy, and in order for it to grow and contribute to the world body of knowledge, more researchers and clinicians must be trained in both pharmacology and sexology.

A Clinical Guide to the Diagnosis and Treatment of Heroin-Related Sexual Dysfunction

It is apparent that a significant degree of sexual concern exists in male and female heroin addicts in the predrug, drug and postdrug periods. The Sexual Concerns and Substance Abuse Project recommends that each opiate abuser entering in to treatment has a brief sex history taken and, if a primary or secondary sexual dysfunction is discovered, then additional evaluation is indicated. Furthermore, the Project stresses the importance of educating the patient to the physiological, as well as psychological, relationship between heroin-related sexual dysfunction and concomitant side effects. For example, in women chronically abusing high doses of heroin, one may not only see a reduction of sexual desire and performance, but also irregular menstrual cycles, and occasionally, amenorrhea, as a result of the depressive effects of the opiate on pituitary hormones. The woman may misinterpret this physiological effect and believe that such changes in her menstrual cycle are irreversible, and that she is sterile. Following the evaluation and patient education phase, the findings obtained from the evaluation of the drug cycle, as it relates to the sociosexual response cycle, should be incorporated into the overall treatment approach for counseling the opiate abuser. When a specific sexual dysfunction exists, particularly if it predates the heroin involvement, referral to a qualified sex therapist is often indicated, to work in co-therapy with the drug counselor and the referring physician. Greater awareness of heroin-related sexual dysfunction may help reduce the relapse rate back to heroin as well as improve the quality of the individuals life during the recovery period.

Overdose of 2.3 grams of intravenous methamphetamine: case, analysis and patient perspective.

Abstract The patient-reported toxicity of an overdose of intravenous methamphetamine is described. The authors report the case of a 34-year old man who inadvertently injected himself with approximately 2.3 grams of methamphetamine. The patient reported disorientation, hallucinations, hyperthermia, photophobia, orthostasis and extreme ataxia. He recovered in seven days without apparent sequelae. The case demonstrates the unusual, temporary neurophysiologic consequences of high-dose intravenous methamphetamine.

Pharmacosexology Update: Yohimbine and Sexual Function

(1985). Pharmacosexology Update: Yohimbine and Sexual Function. Journal of Psychoactive Drugs: Vol. 17, No. 2, pp. 131-132.

Memory deficits associated with clonidine.

Drugs used in the treatment of essential hypertension are among the most commonly prescribed. Some of these agents have primary effects on neurotransmitter systems and are centrally active. Thus, drugs such as a-methyldopa, propranalol, and reserpine have well-established neuropsychiatric complications, ranging from depression to cognitive impairments and psychosis [l]. Since the use of these drugs is widespread and unavoidable, we must be alert to the possibility that these drugs contribute to psychologic complaints and symptoms of our patients. Clonidine, a presynaptic adrenergic a2 agonist, has become well established as a useful and relatively safe therapeutic agent. Its potential for psychiatric morbidity is still incompletely understood. We have recently treated an elderly hypertensive diabetic who developed a memory deficit secondary to the use of clonidine hydrochloride. The patient was a 74-year-old retired white male with insulin-dependent diabetes and hypertension. He had been hospitalized in September 1983 for a depressive illness precipitated by the breakup of his marrige of 42 years. At the time of admission he manifested symptoms of depression, anxiety, insomnia, and suicidal ideation. His depression responded well to doxepin and supportive psychotherapy; doxepin was discontinued after only a few months. By January 1985 he had been free of clinical signs of depression for over 1 year. In addition to his continuing distress over his marriage, he now complained of significant memory lapses, which he had noticed only in the previous 6-9 months. Specific instances included opening the refrigerator and forgetting what he had come for, and frequently forgetting why he had left the house. He reported going for the wrong ball during pool games and, on two occasions, forgetting to take his regular insulin dose. The patient had been treated for hypertension for over 10 years, usually with thiazide diuretics. When these became less effective, other treatments were initiated. A trial of prazosin hydrochloride had been terminated due to postural hypotension.