Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erectile dysfunction (ED) usually exists in combination with depression in men. The comorbidity of the two diseases may bring more troubles to patients, so it is important to find an effective treatment. Recently, DRIVER (Depression Related Improvement with Vardenafil for Erectile Response) trials showed that, phosphodiesterase 5 (PDE 5) inhibitor vardenafil could improve not only erectile function but also depressive symptoms and quality of life in men with ED and depression. Vardenafil was generally safe and well tolerated.
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PMID:[Efficacy and safety of vardenafil in men with erectile dysfunction and depression]. 1559 95

The aim of the study was to analyse the socio-demographic and epidemiological characteristics of the Italian male population affected by sexual disturbances. Men complaining of erectile dysfunction (ED) who called the Pfizer program "Man and Woman in Health" between April 18th 2001 and May 27th 2002 and asked for information about their medical condition, were interviewed by trained doctors using a computer-assisted questionnaire. 16007 out of 25018 calls were considered for statistical analysis. Mean age of callers was 48.8+/-14.2 yr, reporting ED in 83% of cases. In the majority of men ED was severe (58%) and lasting more than 3 yr (25%). Multivariate analysis revealed that diabetes, depression, prostate surgery, heart disease, neurological disorders, liver and renal diseases were all significant and independent contributors to the degree of erectile impairment adjusted for age (p<0.001). The principal concomitant medications were anti-hypertensive (23%), antidiabetic (9%) and cardiovascular agents (6%). Cigarette smoking was present in 24%. On directed questioning of the caller, anxiety and distress were perceived as the most frequent causes of ED (42%) across all age groups, followed by the presence of concomitant disease/s (26%) especially in aging men. Also, a large number of men (41 %) with severe ED waited for more than 3 yr before looking for medical referral. Interestingly, only 19% had ever tried any specific medication for ED. These data indicate that 5 yr after worldwide approval and release of sildenafil, ED is still largely undiagnosed and under-treated, possibly because it is still perceived as a condition mainly due to distress or advancing age and therefore not deserving medical referral. Effective prevention of ED commences with better awareness of the pathological causes by the population and modification of risk factors by the doctors.
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PMID:Are subjects with erectile dysfunction aware of their condition? Results from a retrospective study based on an Italian free-call information service. 1571 52

Dialysis improves most symptoms of end-stage renal disease (ESRD), yet many patients continue to experience sexual dysfunction (SD) during the dialysis treatment. The aim of this preliminary study was to evaluate the frequency and the course of SD during a 6-month dialysis treatment. Additionally, relationships between the level of depression, cognitive impairment and biochemical parameters of SD were also assessed. The subjects were 43 ESRD (25 male and 18 female) on dialysis treatment for at least 12 months. SD was assessed using the Arizona Sexual Experiences Scale (ASEX); the level of depression and cognitive impairment were assessed using the Hamilton Depression Rating Scale (HDRS) and Mini Mental Status Exam (MMSE). Several biochemical parameters were also assessed. All assessments were carried out at baseline and repeated at 6-month follow-up. Of 43 patients, 20 (47%) and 18 (42%) complained of SD at baseline and at 6-month assessments, respectively. Of 25 males, nine (36%) and seven (28%) patients described SD at baseline and 6-month assessments, respectively; erectile dysfunction was the most frequent complaint. Of 18 females, 11 (61%) and 11 (61%) patients reported SD at baseline and 6-month assessments, respectively; difficulties with arousal and reaching orgasm were the most frequent complaints. Both total and item-by-item comparisons of baseline and 6 months ASEX scores did not reveal any significant changes during 6-month period, indicating that patient's sexual functions do not improve with dialysis treatment. For female patients, HDRS scores were significantly higher in patients with SD at baseline (t = 2.15, P = 0.05) and at 6-month follow-up (t = 2.44, P = 0.03) assessments; after excluding the effects of age and duration of dialysis for females using regression analysis, HDRS still significantly (t = 4.02, P = 0.003) associated with the SD. This preliminary prospective study suggests that SD is frequent in dialysis patients, does not remit with dialysis treatment, associated with depression in female patients, and much clinical attention is indicated.
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PMID:Do sexual dysfunctions get better during dialysis? Results of a six-month prospective follow-up study from Turkey. 1582 89

Decrease of libido and erectile dysfunction are reported by male patients during antiviral therapy of chronic hepatitis C, but therapy-associated underlying factors for sexual dysfunction are not well defined. To assess putative contributions of interferon-induced sex hormone changes to sexual dysfunction, we prospectively investigated changes in free testosterone, total testosterone, dehydroepiandrosterone sulfate, prolactin, sex hormone-binding globulin, FSH and LH levels and psychometric self-assessment scores in 34 male patients treated with interferon alfa-2b (5 MIU three times weekly) (n=19)+ ribavirin (n=15) for 6-12 months. Depression was measured by the Hospital Anxiety and Depression Scale. Sexual dysfunction was evaluated by the Symptom Checklist 90 Item Revised and a five-point rating scale assessing sexual arousal disorder. Free and total testosterone decreased significantly during antiviral therapy in close correlation with libido/sexual function. Depression scores increased during therapy and were also significantly associated with sexual dysfunction. However, androgen levels displayed no significant correlation with depression. These results suggest that interferon-induced decrease in sexual function is associated - but not causally related -with both androgen reduction and increased depressive symptoms. These findings may affect care for male hepatitis C patients during interferon therapy.
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PMID:Sexual dysfunction in males with chronic hepatitis C and antiviral therapy: interferon-induced functional androgen deficiency or depression? 1584 27

Hormonal manipulation in the form of androgen-deprivation therapy for prostate cancer was introduced by Huggins and Hodges in 1941 and resulted in a Nobel Prize in 1966. Hormonal therapy initially had been used in metastatic prostate cancer, but the indications have been expanded including failed local therapy, locally advanced prostate cancer, and neoadjuvant or adjuvant therapy in high-risk localized prostate cancer. In view of the magnitude of the problem of prostate cancer and relatively frequent use of hormonal manipulation, it is important for clinicians to be aware of common side effects, prevention, and treatment to improve quality of life and reduce morbidity and mortality in patients with prostate cancer. This review focuses on the common side effects of hormonal treatment such as osteoporosis, anemia, hot flashes, erectile dysfunction, muscle wasting, gynecomastia, decline in cognitive function, depression, increase in body fat and metabolic changes, and their prevention and treatment.
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PMID:Preventing and treating the complications of hormone therapy. 1586 26

Many extravagant physical traits are selected because they are used as cues for mate choice (sexual selection). Why is mate choice driven by costly ornaments? A theory of sexual selection posits that extravagant traits are preferred because are reliable indicators of superior (heritable) phenotypic quality. In particular, the preferred traits can be expressed only in individuals with superior conditions because are handicaps which impose a high cost to the carrier. The human penis achieves its reproductive function by the complex neuro-vascular mechanisms that controls erection. Surprisingly, erectile dysfunction and infertility, two condition which nearly annihilate fitness, are widespread medical conditions which affect millions of people of any age worldwide. The very high incidence of erectile dysfunction appears as an evolutionary paradox. Impotence is associated with all major systemic diseases as well depression and stress. Stress is also one of the causes of infertility. Therefore, male reproduction appears to be extremely sensitive to internal and external stressors. Moreover, erectile dysfunction is a predictor of myocardial infarction and stroke, whereas men with regular sexual activity have lower risk of death due to coronary disease. This large body of medical literature makes erection the best case for a fitness indicator in the human male. We suggest that the fragility of male sexual physiology observed in modern society is the specific consequence of an evolutionary process driven by the handicap principle.
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PMID:Male reproductive physiology as a sexually selected handicap? Erectile dysfunction is correlated with general health and health prognosis and may have evolved as a marker of poor phenotypic quality. 1589 37

More than 30 million men are estimated to have erectile dysfunction (ED) in the United States. Worldwide, ED is estimated to affect more than 150 million men, and that number is expected to exceed 300 million men by the year 2025. The prevalence of ED ranges from 7% in men aged 18-29 years to 85% in men aged 76-85 years. In addition, a recent report showed that 68% of patients with ED aged 18 years and older have at least one comorbid diagnosis of hypertension, hyperlipidaemia, diabetes or depression, and research suggests that ED may be an early indicator of systemic vascular disease. Viagra (sildenafil citrate), the first-in-class phosphodiesterase type 5 (PDE5) inhibitor, was introduced in 1998 for the treatment of ED. In the 7 years since its market launch, more than 750,000 physicians have prescribed sildenafil to more than 23 million men, helping establish an excellent safety and efficacy record. Clinical studies have demonstrated that sildenafil successfully treats ED of varied organic, psychogenic or mixed aetiology, and is effective in men with ED and comorbidities such as hypertension, hyperlipidaemia, diabetes or depression. Sildenafil was a breakthrough medication that addressed a previously unfulfilled medical need. The impact of sildenafil has stimulated academic, clinical and industrial research to better understand the nature of sexual function and develop better treatment and management for sexual dysfunctions such as ED. With the advent of other erectogenic therapies for the treatment of ED, this 7-year update will focus on the unique history and development of sildenafil, its current use and applications and its future directions and indications. Special emphasis is placed on the impact of sildenafil on our understanding of sexual health and on the extensive safety and efficacy data that have been amassed from numerous clinical trials.
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PMID:Past, present, and future: a 7-year update of Viagra (sildenafil citrate). 1592 97

Erectile dysfunction (ED) is a frequent disorder affecting the man's sexual and relational quality of life. French epidemiological studies estimate that the prevalence of ED is between 11% and 44% and prevalence surveys show a correlation between ED and age: the relative risk of erectile dysfunction increases by a factor of 2 to 4 between the ages of 40 and 70 years. Few patients consult their doctor and only a small proportion of them receive treatment and few doctors take the initiative to discuss the question of their patients' sex life. Doctors should now have a good understanding of erectile dysfunction and must be aware of the importance of detecting or at least investigating any erectile dysfunction, which can be the first symptom of an underlying disease such as cardiovascular disease, diabetes, depression, benign prostatic hyperplasia, prostate cancer, androgen deficiency or a drug-induced effect. Demonstration of erectile disorders therefore represents an excellent opportunity to conduct a general work-up, as more than one-third of patients with ED ignore their underlying health problem and management of ED is therefore an integral part of preventive medicine.
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PMID:[Erectile dysfunction: a sentinel symptom?]. 1599 93

Erectile dysfunction (ED) increases in prevalence and severity because of aging processes and related organic, iatrogenic and social problems. Decline of testosterone (T) levels is observed with age and also in illnesses with a common basis of endothelial damage. The T deficiency may lead to decreased energy, mood depression, reduction of sexual desire, but no correlation has been reported between T level and severity of ED, which is mainly a neurovascular disease. In facts, inhibition of phosphodiesterase type 5 (PDE5) isoenzyme with sildenafil, tadalafil and vardenafil enhances vasodilatation in the corpus cavernosum and subsequent penile erection. Absolute pharmacological potency of PDE5 inhibitors is similar and non-selectivity defines the side-effects profile, while their elimination half-life explains not only the different duration of action, but also short and long-term tolerability. Efficacy of PDE5 inhibitors in younger patients is greater in respect to older subjects because of associated pathologies and the decline in hypothalamic-pituitary-gonadal function. T is essential in erectile function, controlling the expression and activity of PDE5 and therefore, androgen supplementation improves therapeutic response to PDE5 inhibitors in hypogonadal subjects. Since sexual behavior is a complex interplay of physical, psychological, and social factors, the possible effect of these drugs on androgen levels and brain function need to be deeply investigated. The ubiquitarious distribution of PDE5 and the availability of selective inhibitory molecules foster newer studies in the treatment of heart failure, pulmonary hypertension, inflammation, and depression. This new progress is certainly contributing to a better medical approach to sexuality and quality of life in aging people.
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PMID:New achievement and novel therapeutic applications of PDE5 inhibithors in older males. 1604 60

Hypogonadism, a disorder associated with aging, can cause significant morbidity. As clinical manifestations of hypogonadism can be subtle, the challenge and the burden of diagnosis remain the responsibility of the clinician. Four different analytic methods were used to predict hypogonadism in men based upon age, the presence of erectile dysfunction (ED) and depression. 218 men were classified by age, serum testosterone level, the presence of ED and depression. Depression was determined by the Center for Epidemiologic Studies Depression Scale (CES-D). ED was assessed by the Sexual Health Inventory for Men (SHIM). Hypogonadism was defined as a serum testosterone level <300 ng/dl. An artificial neural network (ANN) was programmed and trained to predict hypogonadism based upon age, SHIM, and CES-D scores. Subject data was randomly partitioned into a training set of 148 (67.9%) and a test set of 70 (32.1%). The ANN processed the test set only after the training was complete. The discrete predicted binary output was set to (0) if testosterone level was <300 ng/dl or (1) if >300 ng/dl. The data was also analyzed by standard logistic regression (LR), linear and quadratic discriminant function analysis (LDFA and QDFA, respectively). Reverse regression (RR) analysis evaluated the statistical significance of each risk factor. The ANN can accurately predict hypogonadism in men based upon age, the presence of ED, and depression (receiver-operating characteristic=0.725). A four hidden node network was found to have the highest accuracy. RR revealed the depression index score to be most significant variable (P=0.0019), followed by SHIM score (P=0.00602), and then by age (P=0.015). Hypogonadism can be predicated by an ANN using the input factors of age, ED, and depression. This model can help clinicians assess the need for endocrinologic evaluation in men.
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PMID:Predicting hypogonadism in men based upon age, presence of erectile dysfunction, and depression. 1607 1


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