Most patients with mental disorders live at home and want a normal sex life with
their partners, but many psychiatric medications interfere with sexual
function. For many years, such patients have been too shy to discuss such
problems with their family physicians, but at least now, some psychiatrists are
talking about the issue.
Prof. Zvi Zemishlany, head of the Geha Mental
Health Center, wrote about such drugs in the first, recently released issue of
the Hebrew-language Israel Journal of Sexual Dysfunction, and discussed how to
help patients cope with disruptive side effects.
He noted that
schizophrenics, who constitute about 1 percent of the population, suffer from
sexual dysfunction as part of the illness itself through anhedonia (the
inability to feel enjoyment) and other symptoms. Many patients receive drugs
called neuroleptics to relieve their psychiatric conditions, but as many as a
third to two-thirds of them suffer from significant problems in their sex lives
as a result. Attempts to give other drugs, such as those with dopamine, did not
bring benefits and could even make the psychosis worse. Research has shown that
giving men erectile-dysfunction drugs like sildenafil can improve the situation,
but the dosage has to be chosen carefully.
About 15 percent of the adult
population suffers from repeated bouts of depression, and this psychiatric
condition and its influence on sexuality also reduce patients’ quality of life,
Zemishlany wrote. Many of them are given Prozac to relieve their depression, but
studies have shown that sexual dysfunction results from taking this drug among
as many as threequarters of patients.
Some of the selective serotonin
reuptake inhibitors (SSRI) in combination with other drugs can help such
patients improve their sexual function, which in turn can improve their
psychiatric condition. Patients with anxiety and personality disorders have also
reacted well when the right drugs are given to treat sexual problems. Zemishlany
urges doctors to give special attention to such patients and prescribe the right
medications for them, thereby avoiding complications of psychiatric and physical
disorders – on condition that relationships with their partners are satisfying
and lack anger and hostility.
ELECTRIC LIGHT & THICK WAISTS
Thomas Edison tested the first light bulb in 1879, he could never have imagined
that his invention might one day contribute to a global obesity epidemic.
Electric light allows us to work, rest and play at all hours of the day – but a
paper published recently in the journal Bioessays suggests that this might have
serious consequences for our health and for our waistlines.
daily, rhythms, including the sleep-wake cycle and rhythms in hormone release,
are controlled by a molecular clock that is present in every cell of the body.
This human clock has its own built-in, default rhythm of almost exactly 24 hours
that allows it to stay finely tuned to the daily cycle that the Earth’s rotation
generates. This perfect symmetry between the human clock and the Earth’s cycle
is disrupted by exposure to artificial light cycles, and by irregular meal, work
and sleep times. This mismatch between the natural circadian rhythms of
our bodies and the environment is called “circadian desynchrony.”
paper, by Dr. Cathy Wyse of the chronobiology research group at the University
of Aberdeen, focuses on how the human clock struggles to stay in tune with the
irregular eating, sleeping and work schedules of the developed world and how
this might influence health – and even cause obesity.
allowed humans to override an ancient synchronization between the rhythm of the
human clock and the environment, and over the last century, daily rhythms of
routines have gradually disappeared from our lives, says Wyse. “The human clock
struggles to remain tuned to our highly irregular lifestyles, and I believe that
this causes metabolic and other health problems, and makes us more likely to
She notes that “studies in microbes, plants and animals
have shown that synchronization of the internal clock with environmental rhythms
is important for health and survival, and it is highly likely that this is true
in humans as well.” The human clock is controlled by our genes, and the research
also suggests that some people may be more at risk of the effects of circadian
desynchrony than others. For example, humans originating from Equatorial regions
may have clocks that are very regular, which might be more sensitive to the
effects of circadian desynchrony. Shiftwork, artificial light and the 24-hour
lifestyle of the developed world mean that circadian desynchrony is now an
inevitable part of 21st-century life.
Nevertheless, we can help to
maintain healthy circadian rhythms by keeping regular meal times, uninterrupted
night-time sleep in complete darkness and by getting plenty of sunlight during
Wyse believes that circadian desynchrony disrupts the
systems in the brain that regulate metabolism, leading to an increased
likelihood of developing obesity and diabetes.
“The reason for the
relatively sudden increase in global obesity in the developed world seems to be
more complicated than simply just diet and physical activity. There are other
factors involved, and circadian desynchrony is one that deserves further
attention. Our 24-hour society has come at the high price of circadian
desynchrony,” Wyse concludes.
WATCH OUT, ACNE
Doctors may soon have a new
weapon against pimples: a harmless virus living on our skin that naturally seeks
out and kills the bacteria that cause them.
“Acne affects millions of
people, yet we have few treatments that are both safe and effective,” said the
principal investigator, dermatology Prof. Robert Modlin, at the University of
California, Los Angeles’s David Geffen School of Medicine.
virus that naturally preys on the bacteria that cause pimples could offer a
promising new tool against the physical and emotional scars of severe acne,” he
Acne affects nearly 90 percent of the general population in the
West at some point in their lives, yet scientists know little about what causes
the disorder and have made narrow progress in developing new strategies for
treating it. Dermatologists’ arsenal of anti-acne tools – benzoyl peroxide,
antibiotics and the drug isotretinoin – hasn’t expanded in decades.
scientists looked at Propionibacterium acnes, a bacterium thriving in our pores
that can trigger acne; and P. acnes phages, a family of viruses that live on
human skin. The viruses are harmless to humans but programmed to infect and kill
the bacteria. Their research was published recently in the online edition of the
American Society for Microbiology’s journal mBio.
When P. acnes bacteria
aggravate the immune system, it causes the swollen, red bumps associated with
acne. Most effective treatments work by reducing the number of P.
bacteria on the skin.
“We know that sex hormones, facial oil and the
immune system play a role in causing acne; however, a lot of research implicates
P. acnes as an important trigger,” explained Laura Marinelli, a UCLA
postdoctoral researcher in Modlin’s laboratory. “Sometimes they set off an
inflammatory response that contributes to the development of acne.”
over-the-counter pore cleansing strips from the drugstore, the researchers
lifted acne bacteria and the phages from the noses of both pimply and
clear-skinned volunteers. When the team sequenced the bacteriophages’ genomes,
they discovered that the viruses possess multiple features such as small size,
limited diversity and the broad ability to kill their hosts, which make them
ideal candidates for the development of a new anti-acne therapy.
findings provide valuable insights into acne and the bacterium that causes it,”
the researchers said. “The lack of genetic diversity among the phages that
attack the acne bacterium implies that viral-based strategies may help control
this distressing skin disorder.”
The researchers plan to isolate the
active protein from the P. acnes virus and test whether it’s as effective as the
whole virus in killing acne bacteria.
If laboratory testing proves
successful, the researchers will study the compound’s safety and effectiveness
in combating acne in people.