Email Archives The following are email that have been presented to our staff physicians, included are their responses to individual questions and concerns regarding impotence, sexual dysfunction and the various treatment options. If you have questions concerning the causes of impotence or impotence treatment options, please feel free to email the physician. Most inquiries are answered within 48 hours. Return each week for updated email summaries. James - London, Writes: I had a myocardial infarction (heart attack) four years ago at the age of 56 and I have not had any symptoms since the initial attack in 1996. Currently, I am only taking Atenolol 50mg once a day, I have never taken any nitrates in any form. My Cardiologist has given me a prescription for Viagra, do you feel it is safe for me to take Viagra?  Physician's Reply: Although your full medical history and a physical exam would be appropriate prior to agreeing or disagreeing with your current Cardiologist decision to prescribe Viagra---I can discuss a recent study published in the New England Journal of Medicine. Researchers at University of Pennsylvania demonstrated that oral Viagra has no direct adverse cardiovascular effects on men with severe coronary artery disease. In fact, they noted that Viagra had a positive effect on coronary blood-flow reserve. This data followed the consensus of the American Heart Association and that Viagra may be prescribed to individuals with stable coronary artery disease who are not taking any medications that contain nitrates. Jeff - Amsterdam, Writes: I have been taking the medication Prozac for the last three months for mild depression which has helped with my depression immensely. However, since being on Prozac I have noticed that my erections have been sporadic. Prior to taking Prozac I have never had any problems performing on demand. I am only 32 and this inability to have erections is making me more depressed. I have heard that Prozac may cause impotence, should I stop taking the Prozac or can I take Viagra? Physician's Reply: Clinical studies have shown Viagra is safe to combine with most prescription medications EXCEPT NITRATES. Nitrates are used to treat angina or chest pain, the most common nitrate is nitro-glycerin. The question, however, is should I use Viagra to prevail over the side effects of certain medications? Yes, Viagra may be used to prevail over the known side effects of certain medications. If your physician has prescribed a medication that you think may be causing erectile dysfunction (ED) do not stop taking the medication-discuss the use of Viagra with your physician he/she will most likely prescribe Viagra for you. Tom- Rome, Writes: I have been on a beta blocker for hypertension. I understand that these type of medications may cause impotence. Can you give me a list of commonly prescribed medications that may result or cause impotence? Physician's Reply: Yes, there are several prescription medications that may promote impotence symptoms as a side effect of the medication. Please review the following lists of medications that can contribute to impotence symptoms: Prescription medications often cause impotence symptoms as a side effect.  Some two hundred known medications fall into this category including: Antihypertensives medications significantly: beta-blockers e.g. Atenolol, Propanolol and Tenorium. Diuretics medications e.g. HydroDiuril and Lasix. Ace Inhibitors/Calcium Channel Blockers medications e.g. Vasotec, Lotension, Cardizem, Norvasc periodically cause ED, however, they are generally represent an excellent alternative medication for individuals with drug induced ED.   Antidepressant/Antipsychotic medications of almost any label can also result in ED e.g. Prozac, Elavil, Zoloft, Thorazine, Haldol. Note: Many other medications in a variety of classes can periodically cause ED.  If you are taking a prescription medication or over-the-counter medication, regularly, please consult with your physician.  However, never alter a dosage or discontinue a medication without the advice of your physician.   LH-RH Analogs/Antiandrogen medications e.g. Lupron Depot®, Eulexin, Nilandron®, Casodex®, etc.  These medications are used in the treatment of prostate cancer.  They function by decreasing the production of testosterone in the testes and adrennal glands.  The decrease in testosterone often results in ED.   Chemotherapy/Radiation therapy are also significant contributors to ED.  These drugs/treatments are used in the treatment of cancer.