Use of Antidepressants May Decrease Sex Drive

Despite the word-of-mouth on the libido-squashing effects of antidepressants, a policy of “don’t ask, don’t tell” seems to pervade doctor-patient relationships.

According to a University of Virginia study of more than 6,000 adults in 1,101 primary care clinics throughout the United States, sexual problems are twice as prevalent as doctors think they are.

Thirty-seven percent of patients taking one of the newer antidepressants reported some problems with sexual desire, arousal or orgasm; physicians estimated the prevalence to be 20%.

People taking selective serotonin reuptake inhibitors (citalopram, fluoxetine, paroxetine and sertaline) and venlafaxine XR had higher rates of sexual dysfunction than those taking bupropion SR or nefazodone.

The risk of sexual difficulties increased with age, especially in those over 50; higher doses of the antidepressant; other illness and/or medications. Problems were also most prevalent in married people, and in those who smoked six to 20 cigarettes a day.

Because trouble with sex is enough reason for many people to stop drug treatment, people who are having difficulty should bring it up with their doctors.

“Changing antidepressants, or [using] options supported by other studies, such as adding an antidote or lowering the dose of medication might help,” says the lead author of the study, Anita H. Clayton, president and vice chairwoman of the department of psychiatry at the University of Virginia Health System in Charlottesville.

(Journal of Clinical Psychiatry 2002: 63; 357-366)

Hypnotherapy Can Ease Symptomsof Irritable Bowel Syndrome

For many people, especially women, who are twice as likely to have irritable bowel syndrome than men, the disrupted bowel habits cause bloating, abdominal pain and may lead to anxiety and depression.

Now, a large study of patients in the United Kingdom’s National Health Service not only has found that hypnotherapy helps ease symptoms, it also has revealed some major differences in how men and women respond to this mind/body approach.

After 12 weekly sessions with a hypnotherapist and learning techniques, such as relaxation exercises, to do at home between sessions, 78% of the 232 patients had improved bowel habits. Only 9% were slightly worse. All measures of quality of life improved significantly, and there was a reduction in anxiety and depression.

Women in the study outnumbered men 4-1. On average they felt worse than men before treatment and improved most afterward. According to a scoring system of symptoms, women improved 52% compared to 33% in men. In fact, one group of men--those with IBS-related diarrhea--improved least, for unknown reasons.

Among several theories for the gender gap is that IBS affects men’s bodies differently.

(The American Journal of Gastroenterology: 97 [4]; 954-961)

Sports Drinks Provide More Zip Than Flavored Waters, Study Finds

With all the flavored bottled waters and sports drinks to choose from, trying to decide which one is best can make you late for the game. A recent study comparing water and a typical carbohydrate and electrolyte sports drink may help you cut to the chase.

Researchers found that competitive athletes who drank the sports drink--in this case, Gator- ade--tired less quickly and ran faster than those who quenched their thirst with flavored water. Unlike previous studies of endurance exercise, this study looked at mental and physical performance in activities that simulated high-intensity competitive sports with a lot of stop-and-go movement, such as tennis, soccer and basketball.

Ten college athletes did four 15-minute sessions of brisk walking to fast running, including intervals of four-minute sprints and vertical jumping. Questionnaires and motor skills tests to measure performance, mood and concentration were done during brief breaks and the halftime rest period.

Before the exercise session and at specific intervals during the workout, the students drank either the sports drink or flavored water. There was a 37% delay in fatigue among those who drank the sports drink and their mental functioning and mood were maintained, meaning, report the researchers, they were able to keep their “head in the game.”

Although Gatorade is a 6% carbohydrate and electrolyte beverage, J. Mark Davis, professor of exercise physiology at the University of South Carolina in Columbia, says a sports drink with a 6%-8% carb content would probably have the same result. He doesn’t believe the electrolytes are responsible for the results. “The benefits we saw are likely due to the flow of glucose to the brain and better balance between brain chemicals such as serotonin, which is linked to relaxation, and dopamine, which is related to arousal, motivation and energy,” Davis says.

(Medicine & Science In Sports & Exercise; 34 [4]: 723-731)

Tissue Glue Cuts Down on Face Lift Recovery Time

People having face lifts have often felt frustrated by the down time the recovery requires--but that lengthy down time may soon be a thing of the past.

An increasing number of surgeons are using a kind of tissue glue that may hasten patients’ return to public life. The glue is sprayed on the underlying tissues and when the skin is placed down over it, a kind of sticky clot quickly forms to seal the newly positioned tissues together.

The tiny vessels that carry blood and lymph are also sealed, causing less bruising and swelling. Although fibrin sealants are often called “glue,” the spray doesn’t replace stitches. Sealants have been used in Europe for years and appear to be catching on in the United States.

At the annual meeting of the American Society for Plastic Surgery last week, a show of hands in the “What’s Hot” symposium indicated that about a third of surgeons are now using either commercial sealants or those made from the patient’s own plasma. (Commercial ones are made with donated plasma that has been treated to inactivate viruses such as those responsible for HIV and hepatitis. All sealants include some type of bovine or cow protein as well.)

“You do look presentable sooner,” says Los Angeles surgeon Peter Fodor, who has used the glue for about four years for face lifts and tummy tucks. However, he adds, minimal bruising and swelling doesn’t necessarily mean faster healing. Still, for many patients, fewer days in hiding is worth the extra cost, which ranges from $350 to $500.

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Dianne Partie Lange can be reached by e-mail at DianneLange@cs.com.