Sildenafil citrate

For some men the problem of erectile dysfunction, which is the inability to obtain or maintain an erection, has become a hindrance on their sexual performance. This problem comes from age or from inadequate feelings of being unable to succeed in the bedroom. Knowing that they have the inability to perform intercourse can lead to feelings of worthlessness and depression. One such pill, know as 'the little blue pill', or Viagra can help men become more active in their sexual lives by ensuring proper blood flow that causes penile erections.

Sildenafil citrate is the active ingredient in Viagra. Viagra is used to treat erectile dysfunction as well as pulmonary hypertension. Erectile dysfunction affects over 140 million men worldwide. This problem in approximately half of these men have been linked to physical causes, the other half from psychogenic or mental causes. Impotence is affected medically by diabetes, circulatory, urological or neurological conditions.

Under normal stimulation penile erection is caused by the flow of blood through the penis. This process leads to the production of nitric oxide which in turn activates enzymes that produce a chemical called cyclic guanosine monophosphate (cGMP) which is responsible for blood flow in and out of the penis. Sildenafil inhibits an enzyme that is said to destroy phosphodiesterase, an enzyme that inhibits the production of cGMP. cGMP is then allowed to accumulate causing a prolonged existence of blood within the penis which is called engorgement.

Viagra was approved by the Federal Food and Drug Administration on March 27, 1998. The drug was originally studied for use in heart disease and high blood pressure. The Pfizer company saw little effect of the drug on heart problems so decided to market it as an erectile dysfunction drug instead.

Sildenafil is still used today to treat heart problems such as pulmonary arterial hypertension. This drug helps to relax the walls of the heart leading to less resistance. This decreases the work load to other areas of the heart that may be in distress.

While other uses do exist for the drug Sildenafil is it most known for its pill Viagra. Helping men enhance their performance sexually can help them feel better about themselves and enhance their sexual lives.

Deep brain stimulation

Deep brain stimulation is FDA approved for treating the tremor associated with Parkinson's disease. It is not approved yet for the treatment of depression, but clinical research over the last couple of years has been promising.

Clinical research trials are not available at the Mayo Clinic at this time, but are at a couple of sites both in and outside of the United States. It is not clear exactly how this "brain pacemaker" works, but it is thought that the electrical impulses generated by the stimulator reset the brain. This is theorized to return brain functioning to normal (including neurotransmitter levels, such as serotonin, norepinephrine, dopamine, etc.) and thus, treating the depression. As with electroconvulsive therapy (ECT), this is a treatment reserved for severe, debilitating depression.

Deep brain stimulation requires a neurosurgical procedure. During the surgery, electrodes are implanted deep into the brain. Wires from the stimulator are attached to a battery operated stimulator that is implanted in the chest. The battery, stimulator, wires, etc. do have the potential to malfunction. This may require replacement of parts later on. Because this is an invasive procedure, it carries definite risks, some of which are life-threatening. These include, but are not limited to:

• Bleeding in the brain
• Infection
• Delirium
• Unwanted mood changes
• Movement disorders
• Lightheadedness
• Insomnia

In addition, people who have undergone deep brain stimulation to treat Parkinson's disease have reported such side effects and adverse events as panic attack, speech difficulty, movement problems and even suicide.

Since this is a relatively new treatment, long term effects are not known. As with any treatment, discussion with your physician is important so you can understand the risks, benefits and alternatives. Weighing all of the pros and cons is crucial in the decision making process. This will ensure that you are making an informed decision by putting your health care as top priority.