Sexual headache

CS386 Alvaro, L. C., I. Iriondo, and F. J. Villaverde. Sexual headache and stroke in a heavy cannabis smoker. Headache 2002 42(3) 224-226. 

SSRIs are well tolerated. Adverse effects for compounds in this class include nervousness, tremor, dizziness, headache, insomnia, sexual dysfunction, nausea, and diarrhea. In addition, the tricycHc antidepressant clomipramine (33), which is a potent nonselective serotonin reuptake inhibitor, is approved for treatment of obsessive—compulsive disorder. 

SSRIs are widely used for treatment of depression, as well as, for example, panic disorders and obsessive—compulsive disorder. These dmgs are well recognized as clinically effective antidepressants having an improved side-effect profile as compared to the TCAs and irreversible MAO inhibitors. Indeed, these dmgs lack the anticholinergic, cardiovascular, and sedative effects characteristic of TCAs. Their main adverse effects include nervousness /anxiety, nausea, diarrhea or constipation, insomnia, tremor, dizziness, headache, and sexual dysfunction. The most commonly prescribed SSRIs for depression are fluoxetine (31), fluvoxamine (32), sertraline (52), citalopram (53), and paroxetine (54). SSRIs together represent about one-fifth of total worldwide antidepressant unit sales. 

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

Adverse reactions with administration of bupropion include citation, dry mouth, insomnia, headache, nausea, constipation, anorexia, weight loss, and seizures. Fluoxetine administration may result in headache, activation of mania or hypomania, insomnia, anxiety, nervousness, nausea, vomiting, and sexual dysfunction. Trazodone administration may cause the following adverse reactions drowsiness, skin disorders, anger, hostility, anemia, priapism, nausea, and vomiting. Additional... 

Drowsiness, sedation dizziness, headache, fatigue that tends to diminish within 4—6 weeks, dry mouth, constipation, impotence, decreased sexual activity... 

Lethargy, dizziness, insomnia, anorexia, nausea, sexual dysfunction, headache, emotional lability, depression, sweating, acne, breast atrophy, peripheral edema, lower urinary trad symptoms, hot flashes, pain, edema, upper respiratory tract infedion, rash... 

Taken for recreational use as an intoxicant, typical acute effects described by misusers are euphoria, relaxation, and increased sexuality (Galloway et al. 1997 Miotto et al. 2001). On the street, GHB is taken in capfuls or teaspoons of a salty/sour liquid, which because of variations in concentration, may range in dose from 0.5 to 5.0 g. Common side effects are nausea, headache, itching, and vomiting (Borgen et al. 2003). Doses of 10—20 mg/kg of GHB typically... 

SSRIs are the drugs of choice for PD. All SSRIs have demonstrated effectiveness in controlled trials, with 60% to 80% of patients achieving a panic-free state.28,48,49 With similar efficacy reported and no trials comparing SSRIs with other SSRIs, selection generally is based on pharmacokinetics, drug interactions, side effects, and cost differences (see Chap. 35 for more discussion). The most common side effects of SSRIs include headaches, irritability, nausea and other gastrointestinal complaints, insomnia, sexual dysfunction, increased anxiety, drowsiness, and tremor.49 SSRIs should not be discontinued abruptly to avoid a withdrawal syndrome characterized by dysphoric mood, irritability, and agitation. 

Evaluate the patient for symptoms, such as headache, visual disturbances, menstrual cycles in women, and sexual function in men, to assess clinical response to therapy. 

How does physical exercise alleviate depression One possibility is that it increases the release of endorphins that produce a sense of well-being, sometimes referred to as the runner s high . Another possibility is that it is a placebo effect. But even if it is a placebo effect, consider the differences between exercise and antidepressants in side effects. Side effects of antidepressants include sexual dysfunction, nausea, vomiting, insomnia, drowsiness, seizures, diarrhoea and headaches. Side effects of physical exercise include enhanced libido, better sleep, decreased body fat, improved muscle tone, greater life expectancy, increased strength and endurance and improved cholesterol levels. So if both antidepressants and exercise work by means of the placebo effect, which placebo would you prefer ... 

Physical symptoms may include fatigue, pain (especially headache), sleep disturbance, appetite disturbance (decreased or increased), loss of sexual interest, and GI and cardiovascular complaints (especially palpitations). Intellectual or cognitive symptoms may include decreased ability to concentrate or slowed thinking, poor memory for recent events, confusion, and indecisiveness. 

The SSRIs produce fewer sedative, anticholinergic, and cardiovascular adverse effects than the TCAs and are less likely to cause weight gain than the TCAs. The primary adverse effects include nausea, vomiting, diarrhea, headache, insomnia, fatigue, and sexual dysfunction. A few patients have anxiety symptoms early in treatment. 

Buspirone does not share any of the problematic benzodiazepine properties such as sedation, motor impairment, addiction, physical dependence, or withdrawal. The most common side effects of buspirone include dizziness, nausea, headache, fatigue, and dry mouth. Despite its activity in the serotonin system, buspirone is not associated with the sexual side effects that plague the SSRIs, SNRIs, MAOIs, and TCAs. 

Drug abuse and dependence Volatile nitrites, including amyl nitrite, are abused for sexual stimulation, with headache as a common side effect. 

Adverse reactions include nausea, nervousness, headache, insomnia, anxiety. Sexual dysfunction with loss of libido is a common complaint. Insomnia can be a problem. Urticaria and rashes have been described. Venlafaxine may significantly increase the risk of suicide and is therefore not recommended as a first line treatment of depression. The view that also fluoxetine and other SSRIs can lead to suicide is under debate for quite some time now. In most countries SSRIs are not approved for use in pediatric populations. In the UK and in the USA only fluoxetine can be prescribed for children. 

Paradoxical aggression Headache Hypotension Weight gain Sexual dysfunction... 

Buspirone is well-tolerated, with the main side-effects being dizziness, anxiety, nausea and headache. It is tolerated by the elderly (Bohm et al. 1990). It does not cause sexual dysfunction and does not appear to be associated with a discontinuation syndrome. Overdose causes drowsiness but there are no reports of serious toxic effects. A potential for interaction with drugs that inhibit the CYP450 3A4 isoenzyme is not a significant problem in cHnical practice. GAD is usually a chronic condition and buspirone is suitable for long-term treatment. Patients should be advised to expect a slow onset of benefits and be reviewed regularly in the early stages of treatment. 

Headache (60%), hot flashes (55%), depression (54%), diaphoresis (45%), sexual dysfunction (21%), decreased erection (18%), lower urinary tract symptoms (13%) Occasional (10%-5%)... 

Allergic reaction (rash, itching), decreased urination, constipation, decreased sexual ability, enlarged breasts, headache, photosensitivity, nausea, vomiting, insomnia, weight gain... 

Paresthesias, weakness and paralysis of lower extremity, hypotension, high or total spinal block, urinary retention or incontinence, fecal incontinence, headache, back pain, septic meningitis, meningismus, arachnoiditis, shivering cranial nerve palsies due to traction on nerves from loss of CSF, and loss of perineal sensation and sexual function Rare... 

C. P. L. Freeman et al. (1994) compared the efficacy of fluvoxamine with that of CMI in a multicenter, randomized, double-blind, parallel-group comparison in 66 patients. Both drugs were equally effective and well tolerated, but fluvoxamine produced fewer anticholinergic side effects and caused less sexual dysfunction and more reports of headache and insomnia than did CMI. 

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