What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition that affects both children and adults. Individuals with ADHD usually exhibit persistent hyperactivity, impulsivity, and inattention that impair educational achievement and social development [1, 2, 3].
People with ADHD may have trouble focusing on a task or sitting still for long periods. Many people experience inattention and changes in energy levels. For a person with ADHD, this happens more often and to a greater extent compared with people who do not have the condition [2].
ADHD can have a significant effect on an individual's studies, work, relationships, and home life. It can also lead to poor academic, occupational, and social functioning resulting from developmentally inappropriate levels of hyperactivity and impulsivity and impaired ability to maintain attention on motivationally relevant tasks [4].
ADHD is also associated with an increased risk of experiencing comorbid psychiatric disorders, including mood disorders, anxiety disorders, and substance use disorders [5]. It's important to note that the symptoms of ADHD frequently overlap with other categories of psychopathology, which can sometimes make it challenging to diagnose [6].
Erectile dysfunction
Erectile dysfunction (ED) is a common condition that affects men, particularly those over 40 years old. It is characterised by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance [7, 8]. The causes of ED are multifactorial, often involving both physical and psychological factors [9, 10].
Physical causes of ED are numerous and often involve conditions that affect the cardiovascular system, nervous system, and hormonal balance. Common physical causes include:
- heart disease,
- high cholesterol,
- high blood pressure,
- diabetes,
- obesity,
- and metabolic syndrome [9, 11, 10].
Other conditions, such as Parkinson's disease, multiple sclerosis, and Peyronie's disease, which involves the development of scar tissue inside the penis, can also lead to ED [11, 10]. Certain prescription medications, tobacco use, alcoholism, and other forms of substance abuse are also known to cause ED [11, 10].
Psychological causes of ED can include stress, anxiety, depression, and relationship problems. These can either be the primary cause of ED or can exacerbate the condition when it is caused by physical factors [11, 12, 10].
It's important to note that ED can be a symptom of underlying pathologies and is considered an underutilised cardiovascular risk factor. Any disease process that affects penile arteries, nerves, hormone levels, smooth muscle tissue, corporal endothelium, or tunica albuginea can cause erectile dysfunction [13].
ADHD medication that won't cause Erectile dysfunction
Several different medications are used to treat ADHD; some of these medications have been linked to sexual side effects, including erectile dysfunction (ED). It's important to note that not all ADHD medications cause these side effects, and the effects can vary from person to person.
Stimulant medications are commonly used to treat ADHD. However, long-term use of these medications has been associated with an increased risk of testicular hypofunction, which could potentially lead to ED. Atomoxetine, a non-stimulant medication, has also been linked to sexual side effects, including decreased libido and erectile dysfunction.
In conclusion, while some ADHD medications have been linked to sexual side effects, including ED, not all patients will experience these effects. If you're concerned about potential sexual side effects, it's important to discuss these concerns with your healthcare provider. They can help you weigh the benefits and risks of different medications and may be able to recommend alternatives that are less likely to cause sexual side effects.
Other medication for ADHD
While stimulants are often the first line of treatment, several other non-stimulant medications can be used when stimulants are not suitable or effective [14, 15, 16].
Non-stimulant medications include atomoxetine (Strattera), guanfacine (Intuniv), and clonidine (Kapvay). These drugs do not increase dopamine levels in the brain and may take longer to show improvement. However, they are considered less addictive and may be a good choice for individuals who cannot tolerate the side effects of stimulants [15, 16].
Bupropion (Wellbutrin) is another alternative medication that can be used to treat ADHD. It is an antidepressant that can help reduce the primary behaviours of ADHD and comorbid conditions [14, 17].
Tricyclic antidepressants (TCAs) such as desipramine or imipramine can also be effective in treating ADHD, especially in specific comorbid conditions. However, they often produce side effects of sedation, dry mouth, and constipation [18].
Viloxazine (Qelbree) is a recently approved non-stimulant medication that inhibits norepinephrine uptake. It is effective in treating ADHD and has a decreased chance of substance abuse, drug dependence, and withdrawal symptoms compared to traditional stimulant ADHD treatments [19].
In addition to these, other medications such as amphetamines (Dyanavel XR, Evekeo, Adderall), dextroamphetamine (Dexedrine, ProCentra), lisdexamfetamine (Vyvanse), and methylphenidates (Focalin, Aptensio XR, Concerta, Daytrana, Methylin, QuilliChew, Quillivant, Ritalin) can also be used to treat ADHD [16, 17].
It's important to note that the choice of medication should be individualised based on the patient's symptoms, personal health history, and potential for substance abuse. Always consult a healthcare provider before starting new medicines [17].