Tourette's Syndrome and intimacy Best answer on the web
There have been dramatic improvements in SSRIs and related medications over the past several years, and there are also alternatives to that class of drugs. Some medications that aren't on the "officially" recommended lists for treatment of particular problems are nevertheless useful - and prescribed - for those problems. Experienced psychiatrists who specialize in OCD, Tourette's, clinical depression, and related disorders have often done a certain amount of trial-and-error on other patients, and have figured out some good alternatives. If your husband has not tried Tourette's medication since childhood, it probably wouldn't hurt to give it another shot, since medication changes and improves so rapidly.
As others have said, there is also the possibility that the problem is psychological in nature (stress, embarrassment, depression), or is due to some other physiological cause. One thing that urologists often ask new ED patients is whether or not they experience spontaneous (or morning) erections while asleep. If they do, the problem is often (though not always) psychological in nature, or related to anxiety, depression, or stress. If the patient does not experience nocturnal (or morning) erections, then a stronger (though not definite) case can be made for a physiological cause.
There are a number of ways that a urologist can help to treat erectile dysfunction, including variations on vacuum pumping. If you don't have health insurance, check with your local Mental Health county office (if you're in the U.S.) - they can do intake interviews and get him set up to talk to someone about the issues at a rate he can afford (or for free). It wouldn't hurt to join local Tourette's and ED support groups, either, or even subscribe to mailing lists that focus on those issues - invariably you can find someone else who has experienced similar problems and has worked out a solution (or workaround) to them.
I have lifelong (since early childhood), clinical-level OCD, and generally have some erectile dysfunction from the various medications I have tried. I eventually found the right medication combination - the ED comes and goes, but doesn't interfere greatly with my relationship, and the benefits of the meds outweight the drawbacks. It took years to find a combination that worked well with my particular biochemistry, but it was well worth the effort and time to do so.
- Jesse
I found a chart detailing various medications for anxiety disorders that separates the medications by type. There are a lot that aren't SSRI's - but note that a bunch still have sexual side effects. Here's the link:
Anxiety Disorders Assocation of America: Medications
http://www.adaa.org/AnxietyDisorderInfor/Medications.cfm
(click on "Chart")
Also, you may find the other resources on this page helpful, including the "Self-Help Tools" (they have links to support groups in all 50 states and several non-US countries).
I found this page by going to the MedlinePlus topic area for Anxiety: http://www.nlm.nih.gov/medlineplus/anxiety.html. You may also find the resources on the MedlinePlus topic page for Stress helpful: http://www.nlm.nih.gov/medlineplus/stress.html
Good luck!
- Librariankt
As Northtrade2003 noted below, selective serotonin reuptake inhibitors (SSRIs), which are standard drug treatments for Tourette's, are known to have impotence as a side effect. Since your husband isn't taking any drugs, we can rule that out as a cause.
I have not been able to find materials that list erectile dysfunction as a major link with Tourette's Syndrome. However, since both ED and Tourette's are neurological disorders I have to say I'm not all that surprised. What's more, his stress over the TS may be contributing to his problem. Here's a quotation from the very informative Tourette Syndrome Fact Sheet from the National Institute of Neurological Disorders and Stroke:
"Although the basic cause of TS is unknown, current research suggests that there is an abnormality in the gene(s) affecting the brain's metabolism of neurotransmitters such as dopamine, serotonin, and norepinephrine. Neurotransmitters are chemicals in the brain that carry signals from one nerve cell to another." (http://www.ninds.nih.gov/health_and_medical/pubs/tourette_syndrome.htm)
What's more psychological tension is a known "side effect" (for lack of a better term) of TS, and tension is a known cause of ED. A lot of people with TS have other disorders including obsessive compulsive disorder and ADHD. All this is to say that the evidence points to TS as often ocurring in tandem with other neurological problems and psychological problems.
As for your question about anti-anxiety medication, I'd strongly urge you to discuss it with his doctor. Paxil and many of the other drugs used for anti-anxiety and "social anxiety" are SSRIs, which I mentioned above. MedMaster (a drug guide available for free online) mentions that "changes is sex drive or ability" is a known side effect: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a698032.html
The Tourette Syndrome Assocation suggests psychotherapy and biofeedback as ways to address the stress and anxiety that TS may engender (http://www.tsa-usa.org/ - click on "What is TS?"). Another resource for you is the information on Tourette's from We Move: http://www.wemove.org/ts/
So, to sum up: I did not find that impotence is a major side effect of Tourette's Syndrome. I did find that TS is often associated with behavioral and neurological problems. I found that psychotherapy can be helpful for dealing with these problems. My strong recommendation to you is that you talk to your husband's doctor about this issue. This is a serious issue (as you well know) and something the doctor should know about - not just because it can wreck your marriage if left unfixed but also because it could indicate some other medical problem for your husband.
I found the above information by going to the MedlinePlus consumer health index from the National Library of Medicine (www.medlineplus.gov) and looking at the resources they list for Tourette Syndrome (http://www.nlm.nih.gov/medlineplus/tourettesyndrome.html). You might find some of those pages helpful as well. The information on Paxil comes from MedlinePlus' drug information pages.
I wish you the best of luck. Please feel free to ask for a clarification if anything here is unclear or if you'd like more information.
- Librariankt
Medication if its an SSRI can effect erectile dysfunction, however anxiety connected to Tourettes can also cause dysfunction and this needs to be differentiated. More information at http://www.bigsplace.com/
- Librariankt
Is your husband on any medications for the Tourette's? This may have an effect - if you let us know if/what he's taking that would help us answer your question.
- Librariankt
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