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cialis

randomdoc1

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Anyone have experience with this for SSRI induced erectile dysfunction? I've only rx'ed it at 5mg/day. But I see on the label it says for higher doses, it used be used as a prn. Also, what side effects have you personally run into with it? I've only used it with one patient but am curious to learn what other people's experiences with it are. People seem to appreciate that you don't have to time it as tightly compared to viagra. That and it is now available as a generic so it's a great additional option.
 

randomdoc1

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I missed the memo. Since when have we been prescribing this class for ED?
I've maybe had like one SSRI induced ED that the patient quickly stopped it and it resolved.
All other sexual side effects have been libido, orgasm delay, or orgasm inability.
My unfortunate OCD patient that needs an SSRI but he's having difficulty maintaining his erection. I'm using Cialis for him as it kind of kills the mood with the tight timing of viagra. Quick! we got like ___ hours!
 
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VA Hopeful Dr

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Anyone have experience with this for SSRI induced erectile dysfunction? I've only rx'ed it at 5mg/day. But I see on the label it says for higher doses, it used be used as a prn. Also, what side effects have you personally run into with it? I've only used it with one patient but am curious to learn what other people's experiences with it are. People seem to appreciate that you don't have to time it as tightly compared to viagra. That and it is now available as a generic so it's a great additional option.
All the time (disclaimer: I'm FP).

Headaches are the most common but that's more common with Viagra. Make sure they aren't on nitrates.
 
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Yeah, while at VA I gave out Viagra several times per month. It all depends on how comfortable you feel with prescribing those medications. My pharmd helps me in that area. I used to give 100mg tablets and advise to start with cutting in fourths and then halves if that did not work. VA would only give out a certain amount at a time so this is how I got away with giving out more than I think 8 tablets per month. My time there gave me a greater interest in gaining more knowledge about sexual dysfunction disorders and being able to assist patients. Wellbutrin can also be of assistance.
 
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adiradirim

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I see no reason why a conscientious psychiatrist can't prescribe these medications. We should definitely know how to at least initiate treatment for the side effects our medications cause.
 
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Monocles

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When I was an M3 on family med we had a clinic patient come in for that but didn't want to stop their SSRI. I looked up a paper which recommended using cyproheptadine (antihistamine with mild anti-serotonergic effects) .. proposed it to the attending. We gave the guy like a minimal dose (like 1 mg or something) to take with his SSRI daily and it seemed to have fixed him.

Now that I think back on it, it sounds like med student witchery or placebo at best, but hey n=1
 
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birchswing

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You all have liberated patients. For some reason with psychiatrists I've had a certain sort of propriety that I've never discussed such things. Therapists and PCPs, yes, but psychiatrists no. I always assumed it was because psychiatrists were better at creating boundaries such that I felt more inhibited. Maybe just my several experiences, but it's been more buttoned up and serious. It's hard to imagine how erections could come up in those rooms, literally or figuratively.
 
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oldiebutgoodie1211

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When I was an M3 on family med we had a clinic patient come in for that but didn't want to stop their SSRI. I looked up a paper which recommended using cyproheptadine (antihistamine with mild anti-serotonergic effects) .. proposed it to the attending. We gave the guy like a minimal dose (like 1 mg or something) to take with his SSRI daily and it seemed to have fixed him.

Now that I think back on it, it sounds like med student witchery or placebo at best, but hey n=1

isn’t this used for serotonin syndrome? I wonder if this would have an effect on the mood symptoms you’re treating?
 
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