My Writings. My Thoughts.

What Is Depression?

what is depression

The innocuous-sounding word “depression” refers to a potentially disabling illness that affects many but is understood by few. Sufferers often do not realize the nature of their terrible malaise until they are so devastated that they can no longer help themselves, or they may recognize what they have been through only after they are on their way out of the shadows. The reason is simple. Depression is a sneak thief, slipping into a life gradually and robbing it of meaning, one loss at a time. The losses are imperceptible at first, but eventually weigh so heavily that the person’s life becomes empty. Once begun, the course of depression varies with the individual and with the form of the illness. Untreated, it can last weeks, months, or even years.

In the general population, as many as one in five individuals may eventually suffer a significant depressive illness, although most will not seek treatment. During any year, one in ten people experience the sluggishness of mind, body, and spirit we know as depression. The risk is about the same in prepubertal boys and girls, but the ratio alters in adulthood, with females twice as likely as males to become depressed. This two-to-one ratio exists regardless of racial, ethnic, or economic background and has been reported in several countries.

Although depression can occur in very young children, even in those under five years of age, it is more likely to occur for the first time during teenage years or in early adulthood. Depression can also occur for the first time in midlife or later.

Depression tends to run in families. Children of depressed parents have a twofold-to-threefold greater risk of developing depression than children of non depressive parents. Studies of families with histories of depression in many of their members support the theory that predisposition to depression can be inherited. Since the family tendency could be explained by similar environments rather than by genes, twins who have been adopted outside their biological families and reared apart have been studied with regard to risk for depression. Most of those studies show that if one identical twin (identical twins share the same genes) suffers from depression, the second twin will have a 70 percent chance of also becoming depressed, while the risk for siblings who are not identical twins is only about 25 percent. If heredity were the only factor, the shared rate of depression in identical twins would be 100 percent. Since this is not the case, genetics cannot be the only factor involved. At this point, no single gene has been identified as the culprit in causing depression, and it is more likely that several genes are involved.

According to the fertile ground theory, heredity and environment collude to cause depression. Environmental factors that may be important in causing depression include loss of a parent early in life, separation or divorce of parents, rearing patterns, abuse, low socioeconomic class, and recent life stresses.

How a Touch of Prozac Could End the Hell of PMT

TINY amounts of Prozac could end the monthly misery of PMT for millions of women – and their partners, scientists believe.

In studies, the ‘happy pills’ banished the mood swings, bloating, lethargy and pain that blights the lives of up to three quarters of women in the run-up to their period.

The doses given were around a tenth of that used to treat depression and so should be free of the side-effects that have dogged the drug’s use in psychiatry.

Preliminary experiments on rats have had ‘dramatic’ results and researchers believe low-dose Prozac could be routinely used to prevent PMT – pre-menstrual tension – within two years.

Neuroscientist Thelma Lovick, from the University of Birmingham, said: ‘A lot of women experience PMT and a lot of men are on the receiving end. I can’t say we are going to cure everyone but when taken in conjunction with sensible lifestyle changes we are in with a chance.’ Dr Lovick pinned the symptoms on the sharp fall of progesterone that occurs the week before a women menstruates. Normally, a waste product of progesterone called allopregnanolone, or allo, helps keep a lid on brain circuits involved in controlling emotions.

When progesterone levels fall, amounts of allo also fall, and emotions run riot. Prozac is known to raise allo levels, so Dr Lovick decided to see if it would ease the condition in rats.

Very small doses completely prevented the anxiety and increased sensitivity to pain the creatures normally experience.

Dr Lovick told the British Science Festival: ‘It completely blocked the symptoms – we are amazed.

‘The time is right for a controlled clinical trial in women. The solution for PMT could be as simple as taking a pill for a few days towards the end of your menstrual cycle.’ It is likely women would take a pill at the first signs of PMT and one a day for the following week.

Used alongside lifestyle changes such as controlling stress and cutting out sugary foods, it could have a major impact on millions.

Regular strength Prozac lifts depression by raising levels of ‘feel good’ brain chemical serotonin but can cause problems from loss of libido to suicidal thoughts and selfharm.

Dr Lovick said that using around a tenth of those used to treat depression should not trigger any side-effects.

This is because although very small doses raise levels of allo, they do not have any effect on serotonin.

A daily dose of regular-strength Prozac is already sometimes prescribed to ease PMT, but Dr Lovick believes the way forward is a very small dose taken for a week a month.

Professor Tim Kendall, consultant psychiatrist, said that the idea warranted more research. But he warned that self-medicating with Prozac could be disastrous.

He said: ‘It can make you anxious and wound-up and affect appetite. I don’t know if these side-effects would occur at low doses but it would strike me as unwise to start tipping drugs out of capsules.’


ONCE hailed as a miracle cure for depression, Prozac and similar drugs are prescribed to millions around the globe.

Known as selective serotonin reuptake inhibitors, the ‘happy pills’, which include Seroxat and Efexor, keep mood-boosting serotonin in the brain for longer. When introduced in the late 80s, they were seen as safer than previous anti-depressants. But their use has since been linked to suicidal thoughts and self-harm.

This led to advice that patients with mild depression should instead be offered counseling.

It is claimed that many GPs give out tablets rather than condemn patients to a long wait for counseling.

Some GPs say they are pressurised by patients anxious for a ‘quick fix’ to their problems.

20% of Americans have some mental problems

US mental disorders20% of Americans suffer in one way or another from mental disorder. The highest percentage of mentally unstable people – 30% – in the category 18-25 years. Among Americans older than 50 years of mental disorders in varying degrees, affected 13.7%. Scientists explain such high rates of economic instability.

Ireland Is Facing Obesity Epidemic in Just 25 Years

IRELAND faces an obesity epidemic with half of the population likely tobe overweight in just 25 years’ time, a leading Irish health charity haswarned.

The Irish Heart Foundation (IHF) made its bleak prediction after UK figuresshowed the extent of the obesity problem there.

A landmark British study warned that as well as half of all Britons becomingobese by 2032, 86 per cent of men stand to become overweight in the next 15years, while 70 per cent of women will suffer a similar a fate within 20 years.

The IHF issued a stark warning yesterday, saying the worrying obesity trends inthe UK are mirrored in Ireland. It called on Irish politicians to makeprevention of heart disease a number one priority.

Chief executive Michael O’Shea said: ‘Ireland and indeed, Europe, is in thethroes of an obesity epidemicanditisthreateningto reverse the downward trend in mortality from heart disease which hasoccurred over the last 20 years.’ The British health secretary Alan Johnsonsaid that ‘obesity is a potential crisis on the scale of climate change’. Thesenew statistics show that Ireland is heading in the same direction.

The latest figures show that more than 300,000 children in Ireland areoverweight or obese and this is a figure that is growing every year by astaggering 10,000.

One in five adults is now obese andtwo out of five adults are overweight.

International Obesity Taskforce’s 2002 figures show that Ireland’s men are thefourth heaviest in the EU, while women come in at No. 7 in the league table.

MrO’Sheaadded:’Therisk factors for obesity such as heart disease, high blood pressure and highblood cholesterol, are largely preventable and at the foundation we workcontinuously with schools, workplaces and communities to encourage healthierliving.

‘But our efforts can only go so far inanenvironmentwhereitis increasingly difficult to make the healthy choice in what has been describedasthe”obesogenic” environment.’ MrO’Sheaalsocriticisedthe mass-marketing of ‘energy-dense foods to our children’, and said that alack of ‘adequate exercise facilities in our schools and the provision of safewalking and cycling paths’ made obesity even more difficult to control.

The British study, compiled by 250 leading scientists, said the obesity crisisthere is so bad it will take 30 years to reverse.

Modern lifestyles – with the easy availability of cheap unhealthy food andpeople relying too much on their cars – means it is almost impossibleformanypeopleto avoid putting on weight. And the effect on health – both in the UK andIreland – will be stark.

The report expects rates of type 2 diabetes to rise by 70 per cent, strokes togo up by 30 per cent and a 20 per cent rise in coronary heart disease. Therates of certain types of cancer will also go up.

Recently,thedirectorofthe WeightManagementClinicat Dublin’s Loughlinstown Hospital reported that eight out of ten type 2diabetes cases, and four out of ten cancer cases, were because of obesity. Twomore weight clinics, in Cork and Galway, will open within six months.

The British government’s chief scientific advisor, Professor David King,said:’Wemustfightthe notion that the current obesity epidemic arises from individualoverindulgence or laziness alone.

‘We live in a consumer society which encourages us to eat. We have a sedentarylifestyle. It’s an environment which means that if we just behave normally wewill become obese.

‘Wemayonlyputonabitof weight a day but there are 365 days in the year.’ Dr Susan Jebb of the HumanNutrition Research Unit said action against obesity needed to be asstrongas the action taken against infectious diseases in the nineteenth century.

She said people were eating more unhealthily and taking less exercise becausethat was becoming normal behaviour and ‘we act as a herd’.

Is Childhood Obesity Epidemic a Myth?

THE childhood obesity epidemic sweeping the country is a myth, controversial research has claimed.

child obesity

child obesity

A study by the Democracy Institute, which was published yesterday, argues that there is a dearth of evidence to support claims the UK faces an epidemic of obese and overweight children.

And the researchers said there was little evidence to suggest obesity is caused by children eating too much or the wrong sorts of foods.

Academics Dr Patrick Basham and Dr John Luik also said there was no evidence of a link between obesity and food advertising.

The comments contradict official government and Assembly government policies designed to improve children’s health and reduce the number of obese and overweight children.

And they counter comments from Welsh dieticians who told the Western Mail they are treating obese two-year-olds fed a diet of their favourite foods.

Dr Luik, a senior fellow at the Democracy Institute, said: “There are substantial and well-evidenced doubts as to whether childhood obesity is a significant problem, whether in terms of numbers, risk to health either in childhood or adulthood, or in terms of reduced life expectancy.

“It’s tremendous irony that the Government’s claims about childhood obesity are not supported by the facts produced by the very same government.”

The pair’s research – Fat Kids? The Obesity Epidemic Myth – also pours doubts on links between obesity and diabetes, claiming that type 2 diabetes, which is generally accepted asadisease which affects overweight people, is genetic in origin.

Dr Basham, director of the Democracy Institute, said: “There simply is not a body of clinical evidence that shows that overweight and obese children have notably poorer health outcomes than other children.”

Official figures reveal that Wales has one of the highest rates of childhood obesity in the world with 22% of 13-year-old boys and 16% of girls classed as either overweight or obese.

And there is evidence children are already suffering the long-term health consequences. At least 30 children in Wales have already been diagnosed with type 2 diabetes, a condition normally associated with the overweight over-40s.

Dr Tony Jewell, Wales’ chief medical officer, said: “There is a general consensus from health professionals and academics across the world, that having a healthy lifestyle and diet have a positive impact on people’s health and well-being. Clearly, it is best to encourage people from a young age to develop good lifestyle habits that they can take into adulthood.

“Eating a healthy, balanced diet is only one factor in staying fit and healthy. It is also important to ensure children have more opportunities to undertake regular physical activity. That is why we have invested in, among other things, free swimming during school holidays. It is about making it easier for people to make healthy choices.”

Andy Misell, policy and public affairs manager for Diabetes UK Cymru, said: “This report highlights some important issues, but some of the conclusions are wide of the mark.

“It is very important that we discuss what sort of interventions are really likely to bring about long-term lifestyle changes and improved health, but simply denying the existence of the problem is not an option.

“Where work has been done in Wales to measure children’s body mass index, the clear indication is that levels of overweight and obesity are rising sharply.

“The researchers have also confused thing by focusing on the detrimental effects of dieting.

“Most people in the field of diabetes are agreed that short-term weight loss diets are less effective than real changes in eating and exercise patterns that people are able to sustain in the long term.

“Eating a healthy mix of foods, and balancing food intake with the amount of physical activity we do is the key to diabetes prevention and diabetes management.”

US Obesity Could Cost $147-Billion a Year

us obesity cost

America’s expanding waistlines have nearly doubled medical spending on obesity-related conditions which could reach $147 billion a year, a study said Monday.As Congress debated President Barack Obama’s major push to overhaul US healthcare, researchers warned that the prevalence of obesity — which now affects over 25 percent of Americans, up from 18.3 percent in 1998 — and associated medical problems, are behind ballooning overall medical spending.US obesity rates grew 37 percent between 1998 and 2006, pushing obesity-related spending up another $40 billion a year, according to the study published by Health Affairs.Obesity currently accounts for 9.1 percent of all medical spending, up from 6.5 percent in 1998.”The medical costs attributable to obesity are almost entirely a result of costs generated from treating the diseases that obesity promotes,” said lead author Eric Finkelstein, who heads RTI International’s Public Health Economic Program.”Obesity will continue to impose a significant burden on the health-care system as long as obesity prevalence remains high.”Per capita medical spending for obese individuals was $1,429 more each year than for those of normal weight — a whopping 42 percent more. Finkelstein and researchers from the US Centers for Disease Control and Prevention (CDC) and the Agency for Health-care Research and Quality based their analysis on data from 1998 and 2006 medical and health spending surveys, and defined obesity as body mass index above 30.The bulk of obesity spending, the researchers said, is not devoted to treatments such as bariatric surgery, but rather to treating obesity-linked diseases. Excess weight, they noted, is the best predictor of developing diabetes, which costs $191 billion each year.”If not for obesity, these costs would be much lower, as would costs for other conditions caused by excess weight,” the authors said. “The connection between rising rates of obesity and rising medical spending is undeniable.”

Poor Diets, No Exercise – Obesity: 90 per Cent of the Population Could Be Overweight by 2050.

The levels of obesity are increasing throughout the world particularly in North America and Europe. England has some of the worst figures in Europe and also some of the worst trends in acceleration of obesity. In the majority of European countries numbers have increased between 10 and 40 per cent over the last 10 years, but in England this has more than doubled.

UK obese

Obesity in UK

Two-thirds of British adults are now either overweight or obese and, based on current trends, this figure could rise to nine out of 10 by 2050.

Obesity occurs when a person puts on weight to a point where it can seriously endanger their health. Some people are genetically more likely to put on weight but the basic cause is consuming more calories from food and drink than are used in everyday activity.

Rising levels of obesity are due to changes in eating habits and less active lifestyles. The reasons for both of these are complex. They include family patterns of eating and cooking and levels of physical activity which are all determined by level of knowledge, attitude and behaviour.

Cultural and psychological issues also play a major role as do poverty, access to affordable local facilities for healthy food and exercise and, of course, busy lifestyles. This has been made worse by the ease with which we can get cheap, high-calorie fastfoods and the physically-demanding lifestyles that we were once used to have now been replaced by more sedentary jobs and leisure activities.

There are several groups who are at increased risk of obesity – those from poorer backgrounds, people with physical or learning disabilities and people who recently stop smoking. Women, especially women from some ethnic groups such as Black Caribbean and Pakistani women, are more at risk of becoming obese than the rest of the population.

In Birmingham there is a large South Asian population who are at additional risk of developing conditions such as diabetes and heart disease because the weight gained in this group tends to be around the tummy region.

Other high-risk groups include children where one or both parents are obese. The problem facing children and young adults is a big one but it has the potential to be much worse in the future. At the moment at least 16 per cent of children aged two to ten in the Midlands are classed as obese and we have, at about 40 per cent, the highest proportion of women aged 16-24 years who are either overweight or obese. If current trends continue then 20 per cent of all boys and 33 per cent of all girls will be obese by 2020.

Poor diet and a lack of physical activity are mainly to blame. Children tend to watch more TV, play video games and spend time on line rather than pursuing more physical activities as was the case 30 years ago. One real concern is that poor dietary habits and physical inactivity in childhood are often carried through to adulthood and those who are overweight or obese children tend to become overweight and obese adults.

Currently the definition of obesity is based on what is known as the Body Mass Index (BMI). This is calculated by dividing the weight in kilograms by the height in metres squared. A BMI of more than 30 is classed as obese. However this is a rather crude method in that it does not take into consideration the percentage body fat and muscle, gender, ethnic origin or the distribution of body fat. For example, an athlete may have a body mass index of 30 and therefore technically would be classed as obese. Clearly this is incorrect and it is the amount and distribution of fat which is more important.

Fat distribution, particularly around the abdomen, would make an individual more prone to developing not only diabetes but also high blood pressure and problems with their cholesterol.

Obesity in the UK is now accepted as a major cause of social, psychological and medical problems. Obese people are twice as likely to die of heart disease. Obesity will reduce an individual’s life by an average nine years and is responsible for at least 30,000 premature deaths.

More concerning is the rise in Type 2 diabetes which has even been diagnosed in children. This was a condition mainly confined to older and elderly people but it is becoming more common at a younger age. Obese women, for example, are 27 times more likely to develop diabetes than normal weight woman.

The increased number of people with diabetes is associated with an increase in heart attacks and strokes.

The cost of treating obesity is huge and set to rise further with massive implications for the NHS. Treating obesity and its related problems nationally costs the NHS at least pounds 500 million per year and the wider cost to the economy could be an additional pounds 2-3 billion per year. It has been estimated that each year 18 million days of absence through sickness are related to obesity.

Obesity has been highlighted as a national priority for major health policies with several government initiatives addressing this issue.

Recently Health Secretary Alan Johnson and School Secretary Ed Balls published a longterm strategy aimed at tackling obesity. A pounds 372 million plan aimed at schools, the NHS, employers, town planners and individuals has been suggested and this includes pounds 30 million for the creation of “healthy towns to promote physical activity”.

Although the causes of obesity tend to be simple, the solutions are far more complex.

Clearly the major drive to tackle the problem of obesity has to be around improving dietary intake and also increasing levels of physical activity. Simple measures an individual can take, such as avoiding snacking and walking on a daily basis, can help reduce obesity levels.

Indeed many individuals need to make only modest changes in their lifestyle in order to get their weight down and keep it down.

Unfortunately, a common desire is to lose weight quickly so that the impact of the changes can be seen quickly. However, rapid weight loss is often associated with drastic measures and bad diets which are extremely difficult to maintain in the long term. Therefore when these individuals go back to their normal lifestyle the weight is rapidly regained and often with a little more. This is very disheartening and often results in people giving up on trying to lose weight.

In order to shed the pounds and maintain weight loss, healthy eating rather than fad diets, and a moderate increase in physical activity, such as an hour’s brisk walk on a daily basis, would help most people. An average weight loss of up to 1lb per week is good and this can be achieved by making modest changes to both diet and physical activity levels and can be maintained in the long term.

It needs to be remembered that weight gain usually occurs over many years and therefore to try to achieve weight loss over a short period of time and maintain this weight loss is generally unrealistic and, when the weight is regained, extremely disheartening.

Small changes in eating habits can have a major impact on your weight over time. For example, eating an extra 100 calories a day more than you require, which is equivalent to a slice of bread, on a daily basis in a year will result in weight gain of about 10 lbs. If you multiply this by five years then, over a fiveyear period just with one extra slice of bread per day, you could potentially gain 50 lbs in weight.

An increase in physical activity of walking briskly for about one hour a day is equivalent in a year to burning off about one stone in weight. Currently we walk about a mile a day less than we did 20 to 30 years ago.

For those with higher levels of obesity and who have developed problems such as diabetes and heart disease, there are tablets which can help. One such tablet can reduce the amount of fat that is absorbed from the food that you eat.

However, it reduces the absorption of fat by only about 30 per cent and therefore to achieve good results with this you need to be on a low-fat diet.

There are other tablets available which can help you if you feel hungry all the time. These drugs work by suppressing hunger.

However, all these medications are effective only if used as part of general lifestyle changes, which include healthy eating and an increase in physical activity levels. Taken on their own they are unlikely to have any significant impact on weight.

For those who are classed as morbidly obese, that is those who weigh twice as much as their recommended body weight for their height, there is the more drastic measure of surgery. Before this is considered the benefits of surgery will be weighed against the risks.

This is not a procedure which is entered into lightly and, once again, surgery generally is only successful in those who have made some lifestyle changes before their operation.

There are two types of surgery available. The first is a gastric band operation which places a plastic band around the stomach, causing patients to feel full sooner and limiting the amount that can be eaten.

A second operation is more permanent and involves essentially re-plumbing the stomach to prevent it from digesting food that has been eaten.

This is a permanent procedure and once again is considered for those where the risk of obesity outweighs the risks of the operation.

Obesity is a major problem already. If we do nothing now then the future for us and our children looks bleak.

Three People Die in Scotland Every Week Because of Obesity

RECORD numbers of Scots are eating themselves to death as the country’s obesity epidemic spirals out of control. Shocking figures obtained by the Scottish Daily Mail show three people a week die as a result of being dangerously overweight.

obesity is killing youThe number has rocketed by 70 per cent since devolution, according to disturbing statistics compiled by the General Register Office.

Last night experts called for radical action to curb the level of obesity deaths, which lead by around 14 per cent between 2004 and 2005.

Dr Colin Waine, of the National Obesity Forum, said: We are not sitting on an obesity time-bombthe time-bomb has gone off and the consequences are going to be devastating. The rising tide of Scots falling prey to obesity shows that lifestyle and diet are getting worse despite successive multi-million pound healthy eating campaigns.

The latest disclosures also prompted calls for obese children to be taken into care if their parents fail to encourage them to eat more healthily.

Obesity was either listed as the underlying cause of death or mentioned on the death certificate in 158 cases in 2005, the latest figures available just over three per week compared with 139 in 2004a rise of nearly 14 per cent and up nearly 74 per cent from 91 deaths in 1999.

Eighty-five of the 2005 cases were male, showing the problem is greater among men, according to the General Register Office for Scotland.

The figures, described as concerning by ministers, bring the obesity death toll north of the Border to around 900 between 1999 and 2005.

The surge in the number of times obesity is mentioned as a significant contributing factor to a death shows doctors increasingly believe the condition is responsible for a growing number of deaths.

Obesity is believed to cost NHS Scotland [pounds sterling]500million a year and by 2020 it is estimated 25 per cent of the NHS budget across the UK will be spent on treating diabetes and obesity-related conditions if present trends continue.

The condition poses a major risk for chronic diseases including type 2diabetes, cardiovascular disease, hypertension, stroke and some cancers.

North of the Border, 65 per cent of men and 60 per cent of women are overweight and more than a fifth are obese while of Scottish children born in 2001, more than 20 per cent were overweight by the time they reached the age of three-and-a-half.

The National Obesity Forum described the increase in obesity deaths as deeply worrying and called for obese children to be taken into care in extreme cases.

Last year, the Mail told the story of Scottish teenager Emma McAuley who had to have life-saving surgery after her weight rose to 34 stone at the age of only16.

Dr Waine said: Solutions could include legislation to force manufacturers to limit salt content and so on rather than the current voluntary arrangements.

But in the most extreme cases, we have to consider whether obese children ought to be taken into care if their parents ignore health advice for the sake of the youngsters survival. He added: Obesity is a significant risk factor for developing a whole range of conditions, not just heart disease and diabetes.

It does not seem that ministers have curbed the problem despite the investment and that is desperately worrying. Professor Annie Anderson, of Dundee University’s Center for Public Health Nutrition Research, said: Obesity is notjust a genetic problem or a cultural problem or a clinical problem or a psychological problem it is all of these things and that needs to be recognized as we try to deal with a global issue which is posing a major health risk. Research by the University of Edinburgh earlier this year showed the number of people diagnosed with type 2 diabetes the preventable form of the disease will soar by 60 per cent within ten years. The disease is thought to reduce a patients life expectancy by at least eight years and can also lead to blindness, heart attacks, strokes, kidney failure and even amputation.

Diabetes and the problems associated with it already costs Scotlands health service nearly [pounds sterling]1billion a year.

North of the Border, ministers efforts to tackle the obesity epidemic have so far ended in failure despite massive investment.

It emerged in May that Scotlands fat star had been axed after an [pounds sterling]80millioncampaign to tackle the obesity crisis failed to make an impact, seen by some critics as a tacit admission of defeat.

Gillian Kynoch had been appointed as the Scottish Executives food and health-coordinator to promote healthy eating.

Health Secretary Nicola Sturgeon said: It is concerning that the number of deaths associated with obesity has risen.

We recognise that obesity is an increasing problem and poses a very serious threat to health. This is why we are making tackling the problem, particularlyearly in life, a high priority.

Move over Viagra

Ever since sildenafil (Viagra, Pfizer) hit the market in 1998 as the first oral medication for erectile dysfunction (ED), people have been wondering, “What’s next?”

New data presented at a recent meeting of the European Association of Urology demonstrated strong results for two potential new treatments. Bayer AG presented promising data for its investigational phosphodiesterase (PDES) inhibitor, vardenafil, now in phase III studies. In an analysis of 580 patients, vardenafil improved erections in up to 80% of men, as well as increasing the ability to complete sexual intercourse with ejaculation.

In a separate study, vardenafil was found to be highly selective at targeting the PDE5 enzyme. PDE5 selectivity is of potential clinical importance because phosphodiesterases are widely distributed throughout the body, with PDE3, for example, playing an important role in cardiac contractility.

Lilly/ICOS unveiled compelling results for its next-generation PDE5 inhibitor, IC351 (Cialis). In a placebo-controlled phase III study in men with difficult-to-treat diabetes-related ED, up to 64% of men reported improved erections, compared with 25% for placebo.

In preclinical investigations, Cialis demonstrated an even higher affinity for the PDE enzyme than sildenafil did. Researchers saw no significant changes in clinical laboratory values, ECGs, or blood pressure in the phase III trial.

Black Men and the New Sex Pills

BROTHERS might not want to admit it right away, but Sisters and the doctors who know about these things will tell you in a minute that, despite the dominant myths about Black male sexuality, Black men–like all men–can experience sexual problems brought on by life’s typical stresses, relationship tensions, medical conditions or just plain old aging.

Now, thanks in part to a media blitz on the new sex pills, experts are saying they have seen a growing admission among Black men that they can have a sexual problem, and a growing use of a pill to resolve that problem. The result is a high level of satisfaction among those Brothers who have used the pills and enjoyed sex, and a marked improvement in the health of their relationships.

“No question about it,” notes Atlanta-based urologist Dr. James Bennett, who has seen an increase in Black men who are taking sex pills. “Usually, when African-American men come in, it’s at the insistence of their spouse,” says Dr. Bennett, who also hosts “Radio House Call” in Atlanta. “Even the radio show callers tell me how the drug has changed their lifestyle.”

Once thought of as private, sexual performance problems these days are being discussed everywhere, blaring in headlines, in news accounts and ads for new sex pills Viagra and Levitra with their sports celebrity pitchmen, to be followed soon by Cialis, which has been approved for U.S. sales. And a fourth drug, Uprima, is on the pharmaceutical horizon awaiting approval.

Although there are differences among the pills currently on the U.S. market–which cost about $10 apiece–they basically take the same approach, blocking certain enzymes to allow an erection. They merely allow nature to take its course with sexual stimulation.

Clinical trials conducted on behalf of the pharmaceutical companies have shown the pills work for Black men. Viagra showed an 81 percent satisfaction rate among Blacks, and Levitra showed Blacks, Hispanics and Whites at 80 percent. The pills that are out or are coming out try to distinguish themselves in going after the huge segment of the potential market that has been left out. The main differences with these pills are in their relative effective periods–usually about 4 to 5 hours, although newcomer Cialis boasts effectiveness up to 36 hours, giving rise to its French nickname, “Le Weekender.” There also are relative differences in the amount of time it might take for the pills to kick in–from 30 to 60 minutes–and differences with side effects that can include headaches, backaches or facial flushing.

Surprisingly, apart from efficacy studies that show satisfaction levels, there have been no research studies on the impact of the new sex pills on Black sexuality or on Black health. It is still early, but experts in this area say there is need for just that kind of research.

It has been estimated that up to 30 million men in this country have at least some episode of impotency at some point, with a number of men facing chronic occurrences after they pass age 60. Reportedly as many as 50 percent of men over age 40 can be affected to some extent, and even much younger men can have episodes–sometimes health-related.

While there are no hard figures, there is reason to believe Black men–especially Black men over age 40–may face increased risk. Apart from the emotional causes, like problems in a relationship or everyday stress, there are certain medical conditions that are commonly associated with male sexual performance. Diabetes, coronary disease, hypertension and certain cancers all can give rise to sexual performance problems, and these are medical problems that affect Blacks to a higher extent than the general population.

That is why it is critical for Black men to address any sexual problem right away. It just might be an early warning sign of more serious medical problems, according to Dr. Bennett, who also served as lead investigator for American clinical trials on the efficacy of Levitra. “That’s the message we need to send out to our community. Regardless of your age, whether you’re in your late teens or twenties or thirties, if you have any signs of erection problems,” he advises, “that is a sign that you could have some underlying cardiovascular problems. And you need to get checked out. It’s nothing to get embarrassed about, but it may save your life down the road from a stroke or a heart attack or even going into renal failure.”

A doctor will also advise on potential side effects, how certain products might affect Black men with special health concerns, and whether a man’s particular physical condition poses a risk. Your medical history and prescriptions are critical in making this determination, because there is the very real possibility that certain medical conditions and medications for those conditions—like hypertension medication–can be adversely affected by use of sex pills. No one who is on nitrates–prescribed for certain heart conditions–should use these medications. Similarly, a recent heart attack or heart irregularity would likely bar any use of these drugs for a certain period of time. Diabetes and prostate cancer might be factors in determining not to use certain medication.

Still other men might have simpler causes of sexual problems that can be addressed without drugs. “So I think it is a matter of making sure you have the right assessment to determine whether you need medication,” suggests Dr. David Satcher, director of the National Center for Primary Care at the Morehouse School of Medicine. “There are many men who will not need medication in order to deal with their erectile dysfunction,” says Satcher, the former U.S. Surgeon General, who notes that physical activity or counseling just might be enough.

Everyone agrees that women partners should be involved in any effective counseling, improving the overall satisfaction in the relationship. “It says that my partner cares enough about me to go in to the doctor to talk about something so that our lives can be better,” notes Dr. Gail Wyatt, sex therapist and professor of psychiatry and behavioral science at UCLA. “No matter what the outcome is, we’re going to get better because we’re in this together,” she says.

Despite the growing acceptance of medical treatment among Black men, dealing with it so openly still is hard. “Men do hide from this and they will ask for the pills through their wives or they will ask someone else about the medication,” notes Dr. James Wyatt, an obstetrician/gynecologist and sex therapist. “They don’t like to present themselves at a physician’s office saying, ‘I am not a stud, I can’t perform,’” says Dr. Wyatt who, with his wife Dr. Gall Wyatt, co-authored the book No More Clueless Sex: Ten Secrets to a Sex Life that Works for Both of You. “It’s embarrassing and it’s self-deflating for them to do that.”

Looking ahead, experts say, Black men will have to face the reality of life, rejecting the myth of Black male sexuality. In the end, for couples who have a healthy attitude about their sexuality and their relationship and where the man can use a sex pill, the relationship benefits. “It certainly can increase desire because if you’re able to perform, you’re going to want to try again,” Dr. Gall Wyatt says. “If you’re not, then you’re going to want to avoid sex, and avoid intimacy.”


An informal, unscientific survey in the Black community suggests that many Sisters applaud high-profile sex pills such as Viagra and Levitra and say that these drugs are saving marriages and, in some cases, lives. “We know that if the sex is not good in a relationship, it can affect that relationship in various ways,” says Charlotte, N.C., psychologist Elaine Stevens, founder and president of the relationship consulting company, Matters of the Heart, Inc. “The positive thing that has happened in Black relationships is that a lot of couples, where the partner was once impotent, are now able to have an enjoyable sexual relationship, so their marriage is back.”

Los Angeles-area sex therapist Rosie Milligan, author of Satisfying the Black Man Sexually, Made Simple, agrees, adding that these sex drugs also save lives. “Black men [suffer] higher fates of high blond pressure and diabetes, and the prescribed medications for these ailments may impair their ability to perform,” Milligan says. “Before [the new sex pills] came along, many men would rather risk their lives by not taking their blood pressure medicine.”

But if it takes two to tango, many Sisters have one burning question:

Where’s our miracle drug to combat sexual dysfunction?

“Viagra enables men to have more confidence in themselves and to perform, and that’s a blessing,” says Nr.w Ynrk-area psychologist Vera S. Paster, author of Staying Married.” A Guide for African American Couples. “But the real problem is that there should be a ‘Viagra’ for women.”

To date, there still isn’t an FDA-approved impotence medication for women on the market. Same doctors, however, are experimenting with low doses of Viagra and Levitra to treat female patients; and others, like Shaft Goldman, a Chicago-area gynecologist, told a reporter that she considers testosterone therapy for women who say they suffer from low libidos.

Alicia Simon, assistant professor of sociology at Clark-Atlanta University, says women’s sexual issues are gradually becoming the focus of research.

“The [impotency drug] revolution is a good thing, because once they do address the male reproductive issues, then our issues will gel addressed as well, so eventually we will all benefit.”

Perhaps the greatest benefit is the promise of re-igniting the passion in Black relationships, says Detroit-area psychologist and attorney Paris M. Firmer Williams, author of Marital Secrets: Dating, Lies, Communication and Sex. Dr. Finner-Williams believes that couples who become intimate at least once every 72 hours are more likely to succeed.

“Sex is very important in keeping spirituality between the couple,” she says. “Despite all of the issues and concerns that are surrounding us, if we are able to make love and appreciate each other’s spirits, we can once again reassure ourselves that there is a compromise. We can make it. We can resolve whatever our issues are. And we are not going to let those issues separate us.”

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