Is sertraline safe for long-term use
Expect the unexpected
A growing bust size in men can also be a side effect with other active ingredients that is not directly obvious in comparison to the examples mentioned. There are several case reports that the H.2- Ascribing such an effect to the receptor blocker cimetidine. Apparently the active ingredient displaces androgens from the receptors on the mammary gland and also inhibits the breakdown of estrogens. This side effect has also been reported several times with the gastric drugs ranitidine and omeprazole as well as with the diuretic spironolactone.
In addition, intoxicants such as marijuana, alcohol and heroin as well as other active ingredients, for example certain calcium antagonists such as nifedipine and verapamil, certain beta blockers such as atenolol and propranolol, the HIV active ingredient efavirenz and digoxin can trigger this side effect. Good news: drug-induced gynecomastia is generally reversible after the trigger is stopped.
Painful permanent erection
Men are also the only ones to suffer from another side effect. Priapism is a painful stiffening of the male member that lasts for at least two hours and is not due to sexual arousal.
There are several reasons for this. One of them is taking certain medications. First and foremost, you have to think of PDE inhibitors such as Sildenafil and Co. But also drugs that are injected during the cavernous body autoinjection therapy (SKAT), as well as some blood pressure drugs, such as prazosin and nifedipine, psychotropic drugs such as trazodone and chlorpromazine as well as immunosuppressants and corticoids are possible triggers. The American FDA recently pointed out the risk of priapism with drugs containing methylphenidate. The ADHD active ingredient atomoxetine could - and even more often - lead to this (5).
Nightmares after ingestion
The very idea of priapism should be a horror for many men. Real nightmares or at least abnormal dreams or increased dream activity can be the result of different medications - and this in both men and women.
According to the specialist information, abnormal dreaming occurs very often when taking the anti-malarial drug mefloquine (Lariam®) and the active ingredient varenicline (Champix®) on. Also the HIV active ingredient efavirenz (among other things in the HIV fixed combination Atripla® contain) and the antidepressant mirtazapine often trigger abnormal dreams. Interestingly, the specialist information on beta blockers such as bisoprolol and metoprolol also contains information on nightmares or increased dream activity that occasionally occur during therapy.
Moonstruck by Z-substances
Nightmares aren't the only side effect of medications related to well-deserved sleep. Getting out of bed at night and doing weird things that you won't remember later: Some drugs have been linked to sleepwalking. These include the Z-substances.
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