Some caveats on the use of Viagra

I have heard in the mouths of patients or groups of teenagers, and read in various media, on a frivolous or recreational use of Viagra among young people, "bowling", "raves" or "disk" combined with alcohol, drugs such as cocaine, ecstasy or "Poper.

With alcohol there is no real contraindication but a prevention: alcoholic beverages tend to lower blood pressure and that can be enhanced by the joint use with this medication. So while taking sildenafil fortified look very fun, fashion, or mode, but can have complications.

The "Poper" which is inhaled, amyl nitrite is basically (the famous "lanzaperfume" of yesteryear) which itself can cause hypotension with dizzy and fainting. Viagra is contraindicated with nitrites and nitrates (drugs used as coronary vasodilators), therefore I tell you, dear young people, who use in association with the "Poper" serious risk to their health, and is not only a statement "mask" is not only a preventive ethics, but with discretion to avoid fainting, fainting and shock states.

Viagra should be used with caution with cisapride, cimetidine, erythromycin and macrolide antibiotics (erythromycin, clarithromycin), with astemizole and some antifungals (ketoconazole, itraconazole), protease inhibitors (used against HIV), certain antidepressants ( fluvoxamine and nefazodone) for patients with polypharmacy must always take precautions, but this is not the prerogative of sildenafil but of all drugs: today in medicine is given great importance to drug interactions, even as the antidepressant herb St. John's wort or yohimbine and even grapefruit juice that inhibits cytochrome liver, so that any limitation must be in the hands of doctors.

With the combined use of cocaine, ecstasy or amphetamine-and isolation are at risk because these drugs are neurotoxic or cardiotoxic-and Viagra seems to me an unreasonable use of a real drug, when it is safe and effective prescription for indication care.

I think many young people have fallen under the net of performance anxiety, for "failing to fail when drunk or Falope" (words of a patient) which leads to take positions that endanger their health.

Another thing that I want to alert the general population is one of the myths which says that "Viagra is no need to do further studies or medical advice. This is totally false. Absolutely exclude the diagnosis of erectile dysfunction (impotence), according to the discretion of the physician, the clinical and psychological well-ordering of blood tests and studies to warrant specific or each case whether or not factors cardiovascular risk: Ergometries, chest radiographs (in chronic smokers, eg.) prostate studies, controls blood pressure (I can assure you detect hypertension, diabetes, or high cholesterol, hormonal or heart problems in patients who neither knew that suffered or other that having had previous records, turned a blind eye) and clinical examinations. I can say that often erectile dysfunction is a predictor, a marker of another underlying pathology (which may often take for depression). In some tables you can do psychological tests. They care not for the use of Viagra but because it is bad medicine to prescribe the symptom only and neglecting the distortion that many patients suffer from impotence.

It is important to correct the risk factors for improving the quality of life so much that sildenafil is more effective, as we demonstrated in a paper presented at the Congress of Psychiatry in Chicago 2000: Patients who had no cardiovascular risk factor (hypertension, diabetes, sedentary lifestyle, obesity, smoking, alcoholism and substance abuse, high blood lipids) the response was almost 100% in those who had 1 risk factor for response to sildenafil was down to 85.7% and those with 2 or more fell to 78.9%, which advises reducing them by two reasons: improved quality of life and erectile response to sildenafil. I never tire of repeating that many patients who came to the office seeking the use of Viagra could then take charge of neglect they had fallen: they are heavy smokers or drinkers, those with sedentary lifestyles and stress, with diabetes and cholesterol out of control with circulatory symptoms which, oddly enough, would never have asked for such situations but by the impotence sexological consultations then able to review the situation.

When consulting a doctor, and may be in a hospital or a health center, or a Social Work-I think it is working properly: caring for patients is also careful, as it is not when you sell a remedy (including psychotropic drugs) without prescription.

Viagra (sildenafil citrate) is a medication for a medical condition such as erectile sexual dysfunction-that young people may also experience that changed the history of Pharmacology, sexology and medicine, marking a road (now new drugs continue as tadalafil or vardenafil) which no return: the fact of knowing the intimate mechanism of erection and the specific action of the drug in the specific place, promises to men not to neglect other essential factors of eroticism, that does not pass only pills or by his genitals or the erect phallus-a long and satisfying sex life.

* DR. ADRIAN Sapetti, psychiatrist, psychotherapist, clinical sexologist, President of the Sociedad Argentina de Sexualidad Humana, author of "Sex and the man of today"; director of the Sex Doctor, Buenos Aires, Argentina.