instruction: hello doctor I am 35 years old I am taking the following medicines for the past seven years but I am extremely suffering from erectile dysfunction and premature ejaculation what can I do bisoprolol 5 my once daily flupentixol and melitracen 5mg 10mg once daily theophylline 400 my twice daily aspirin 75 my once daily montelukast sodium 10 my in the evening atorvastatin 10 my once daily clonazepam my amlodipine and telmisartan my 80 my once daily kindly advice
output: hi why are you taking anti depressant and antipsychotic drugs that too for so long time why these medicines were started are you also suffering from some heart problems please reply so that I may guide you accordingly regarding erectile dysfunction most of the antidepressants do cause dysfunction I would suggest you to consult a psychiatrist to taper down antipsychotic medicines or replace with other ones as for as cardiac point of view bisoprolol also causes erectile dysfunction in some patients replace this medicine with nebivolol 5 my which also enhances erections you are taking aspirin atorvastatin bisoprolol which are usually given for ischemic heart disease which is uncommon in this young age in old age blockage of arteries also causes erectile dysfunction but in young age this is less likely if this problem started suddenly then most probably due to anxiety or depression if progressed slowly over years I would advise you to have penile doppler ultrasound done but before that I would recommend providing a bit detailed history of your past illnesses family history so that costly investigations may be avoided follow up with detailed history