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

When 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.

Circadian, or 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.”

The 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.

Electric light 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 become obese.”

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 daylight hours.

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.

“Harnessing a 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 said.

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.

The 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.

acnes 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.”

Using 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.

“Our 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.

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