Suffer Night Sweating. Suffer Mild Depression Due To Divorce. Taking Methamazole, Adderall And Wellbutrin. What Can Be Done?

Posted on Fri, 30 Aug 2013

Question: 36 year old male. Caucasian. 5'11. 178lbs. Active, exercises 3x/week & good physical shape. Married for 9 years, but currently separated & divorcing. 2 children (boy 8, girl 3.5) Issue: Frequent inability to achieve full erection, even with consistently healthy sex drive. Would like to determine if cause is physical or psychological, in particular if any daily habits or any current medical conditions and/or their prescribed medications are at work here. Would also like to completely eliminate the issue. Open to any non-surgical treatment options. Current conditions & prescribed meds: Hyperthyroidism (5mg methamazole daily, past 4 years, currently taking), ADHD (45mg adderall AM daily, was @ 90mg daily for past 4 years: 60mg AM, 30mg PM, but self transitioned to 45mg daily AM 10 months ago with no noticeable side effects), OSA complicated by smaller than average airway & deviated septum (CPAP/BIPAP used frequently for 3 years, but discontinued use 7 months ago), mild depression due to divorce & job (weekly therapy sessions past 11 months & ongoing, 45mg Wellbutrin for 3 months then taken off by treating physician 8 months ago), moderate to severe depression (onset 4 years ago, 30 mg Celexa 1x daily & weekly therapy sessions for 1.5 years each, then self-discontinued 2.5 years ago), ED (self-diagnosed mild to moderate frequent inability to achieve full erection, past 3 years, healthy sex drive, declined meds) Family (extended to grandparents, aunts & uncles) medical history: stroke (paternal), hyper & hypo thyroidisim (maternal), high cholesterol (maternal), depression (maternal), bi-polar (paternal).

Answered by Dr. Susanta Padhy (41 hours later)

Thanks for a detailed history

I did go through it

What I can think of, is that, the possible factors for impaired erection could be following,
1) Issue of separation and divorce leading to depression,
2) OSA,
3) Medication use - WELLBUTIN AND CELEXA (but, I suppose, currently, you are off celexa and wellbutin). The effect of medicines is reversible.

One good way of differentiating medical versus psychological cause for impaired erection is doing a penile doppler study.

In addition, looking at your family history, I suggest such patients to do blood sugar, lipid profile, as bare minimum investigation to rule out diabetes and high fat.

After narrowing down the causes we can talk about the non surgical options of the therapy. I am available for further discussion.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar