Dr. J – question about ADHD, use of Concerta and Erectile Dysfunction

[Anonymous]

Dr. J.,

You noted in the Sex and A.D.D. topic on this board that you frequently find patients require ED drugs in addition to their meds for ADHD. Can you elaborate on why this is often the case? Is it a result of the anxiety or depression that often accompanies ADHD or inherent to the condition itself?

Can you also comment on the instances (albeit very rare) where Concerta and other drugs used to treat ADHD can cause ED?

My background is the following:

Male, diagnosed with ADHD at the age of 43, currently on Concerta and suffering from occasional psychogenic ED for the last 15 + years. I had a very active sex life prior to my developing the ED problems in my late 20’s, which I attributed to periods of situational depression and anxiety in my life. I’m know understanding that the ED (along with the anxiety and slight depression) are all likely related to the ADHD. I should note that I’ve had some stable and enjoyable sexual relationships with several women since my ED issues began, but that the sexual success of them depended on my frame of mind at the time. If I was anxious or not feeling comfortable with the relationship or my life in general, the sexual intimacy was difficult to maintain.

My ADHD diagnosis and subsequent use of Concerta coincided with the beginning of the end (surprise, surprise) of my marriage. As things were strained between my wife and me, sex was almost non-existent and less than fulfilling the few times we tried due to the anxiety/depression problems described above, so I never picked up on any potential ED problems stemming from the use of Concerta.

However, I’ve since entered a new relationship and to make sure things get started off on the right page sexually, I’ve been using Viagra – which I’ve used successfully in the past. However, I’ve noticed that if I’ve taken my Concerta dose, Viagra doesn’t seem to be as effective. Additionally, I’ve noticed that even when masturbating while on Concerta, I have a difficult time getting and/or maintaining an erection. Please give me your thoughts.

Has anyone else had similar issues or experiences?

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[Author]

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