Use of neuro-psychiatry medicines in patients with sexual dysfunction: a retrospective study

Background: The objective of the study was to understand the usage of neuro-psychiatry medicines in patients presenting with symptoms of sexual dysfunction.Methods: Medical records of adult patients consulting in the clinic out patients with symptoms of sexual dysfunction were screened for prescriptions of neuropsychiatry medicines. Common neuropsychiatric co-morbidities and prevalence of usage of medicines used for treating neuro-psychiatric disorders was calculated.Results: A total of 628 patients with sexual disorders were included of which 57 (9.1%) had received at least one neuro-psychiatry medicine at the time of presentation. Three most common sexual problems were unconsummated marriage 16 (28.1%), psychogenic ED 14 (24.6%) and organic erectile dysfunction 8 (14.0%). A total of erectile dysfunction 46 (7.3%) patients had psychiatric comorbidity. Five most common neuropsychiatric co-morbidities were anxiety 14 (30.4%), schizhophrenia 10 (21.7%), stress 7 (15.2%), depression 6 (13.0%) and epilepsy 2 (4.3%). The most commonly used neuro-psychiatry medicines were fluoxetine 15 (19.7%), risperidone 11 (14.5%), clonazepam 10 (13.2%), escitalopram 9 (11.8%), alprazolam 5 (6.6%), olanzapine 5 (6.6%) and gabapentin 4 (5.3%). Amisulpride was used in 3 (3.9%) patients whereas valproate, fluoxamine, diazepam and paroxetine were used in 2 (2.6%) patients each. Phenytoin, imipramine, carbamazepine, venlafaxine, haloperidol and sertarline were used in one patient each.Conclusions: Anxiety, schizophrenia and depression are the most common neuropsychiatric disorders in patients with sexual dysfunction. Many patients presenting with sexual dysfunction are already on neuropsychiatry medicines. Further studies are required to evaluate the association between neuropsychiatry medicines and sexual dysfunction in Indian patients. 

An acute experimental study to evaluate the effect of gatifloxacin on blood sugar levels in diabetic and non-diabetic rabbits

Background: Diabetes mellitus is a condition characterized by chronic hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiencies in insulin secretion and/or insulin action. The objective of this study was to evaluate the effects of gatifloxacin on blood sugar levels in non-diabetic rabbits and alloxan induced diabetic rabbits.Methods: Animals were fasted for 20 hours. Blood was collected for baseline investigations. After giving single oral dose of 2% gum acacia blood samples were drawn at 1, 2 and 4 hours for estimation of glucose and serum insulin. After 2 days a repeat blood sample for baseline was collected after 20 hours fasting and single oral dose of gatifloxacin 25 mg/kg was given. Samples of blood were taken at 1, 2 and 4 hours. After a wash out period of 7 days injection alloxan 140 mg/kg was given slowly intravenously to induce diabetes in the animals. On day 3 after alloxan induction, blood samples were taken from the animals (fasting 20 hours), for baseline investigations. Same procedure of blood collection and timing was followed as done before diabetes induction. The animals were given a single dose of gatifloxacin 25 mg/kg with blood samples drawn at 1, 2 and 4 hours for FBS and serum insulin.Results: In non-diabetic rabbits, the effect of control and gatifloxacin on FBS levels at 1, 2 and 4 hours after administration was 100.3, 101.35, 102.89 mg/dl and 73.83, 73.04, 82.11 mg/dl respectively, on serum insulin levels at 2 hours interval was 3.62 and 4.16 μ IU/ml respectively. 48 hours after alloxan induction FBS and insulin levels were 219.13 and 1.19 μ IU/ml. After alloxan induction, FBS levels at 1, 2, 4 hours for control and gatifloxacin are 221.01, 224.13, 228 and 218.60, 218.53, 220.01 respectively. At 2 hours interval serum insulin levels were 1.15 and 1.21 μ IU/ml for control and gatifloxacin.Conclusions: This study is in line with previous reports that gatifloxacin causes increased release of insulin leading to hypogycemia. The fall in blood sugar levels following a single oral dose of gatifloxacin is not limited to diabetic states alone and is more marked in non-diabetic rabbits