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----------------------------------------------------------------------- New impotence therapies may soon be available ----------------------------------------------------------------------- BETHESDA, Md. (October 27, 1997 5:46 p.m. EST http://www.nando.net) Millions of impotent American men are about to get a treatment revolution -- new pills that promise to restore sexual function without the embarrassment and discomfort of traditional therapies. The first oral medicine for impotence -- a drug that can cause erections within 20 minutes of swallowing the pill -- could be sold by April, impotence specialists said Monday. "Some of these drugs are very potent, very unique," said Dr. Harin Padma-Nathan of the University of Southern California and director of The Male Clinic in Santa Monica, Calif. "We could combine them in a cocktail, ... some to work in the brain and some to work locally, for the best effect." Patients who have tried the experimental pills say they work easily. "My wife said it was like I was Tarzan," said Alfred Pariser of Los Angeles, who was impotent for a year following prostate cancer surgery until he tried Viagra, the drug that works in 20 minutes. Between 10 million and 20 million American men suffer impotence at some point in their lives. Impotence increases with age, and some 80 percent is caused by disease, particularly diabetes and heart conditions that restrict blood flow, said Dr. Irwin Goldstein of Boston University. Impotence also can be psychological or a side effect of certain drugs. Impotence is highly treatable, but there are drawbacks: penile implants require surgery; vacuum-style devices that force blood into the penis interrupt lovemaking; injecting drugs into the penis or inserting a drug-carrying pellet into the urethra can be painful, and the injections sometimes cause hours-long erections. Now three experimental pills promise to erase the discomfort, doctors told reporters meeting at the National Institutes of Health Monday: * Pfizer Inc.'s Viagra, or sildenafil, blocks an enzyme found mainly in the penis that breaks down a chemical produced during sexual stimulation. The longer that chemical, called cyclic GMP, stays around, the better chance of an erection. In clinical studies of several thousand men, Viagra helped about 80 percent, said Padma-Nathan, who helped test all three drugs. The Food and Drug Administration last week promised a quick review of Viagra, meaning it could be sold by April. Unlike injection drugs, Viagra doesn't cause erections unless the man is sexually stimulated. "If I take the pill and ... my wife suddenly has a headache or her mother calls and she's no longer in the mood, nothing happens to me," Pariser said. "This drug is the most natural, normal thing you can take." Viagra was a failed heart drug investigated again after some heart patients unexpectedly reported erections. Some 10 percent of patients report mild side effects such as headache or flushing. * While Viagra works in the penis, Tap Pharmaceuticals Inc.'s apomorphine "works completely in the brain," Padma-Nathan said. Apomorphine affects chemicals in the brain region associated with initiating erections. Doctors discovered the effect in 1869, but found the drug better for poison victims because it also caused serious nausea and vomiting. But Tap created a "sublingual" version -- it dissolves under the tongue -- that gets into the body so slowly that it doesn't cause nausea. The drug is 70 percent effective in the psychologically impotent, and studies in disease-caused impotence are concluding now, Padma-Nathan said. Tap had planned to seek FDA approval in 1999, but Padma-Nathan said Monday that the drug works well enough that the company may act sooner. * Vasomax is an oral version of a current injection drug that dilates penile blood vessels. Trials show it can help about 40 percent of men with moderate impotence. Manufacturer Zonagen Inc. is expected to seek FDA approval by year's end. This first generation of easier impotence treatment could persuade more men to seek help, from the 5 percent to 10 percent who do today to half of patients, Padma-Nathan said. That's just the first generation of easier impotence treatment. Animal experiments promise that gene therapy may one day allow men to battle impotence over long periods by taking just two or three shots a year, said Dr. George Christ of the Albert Einstein College of Medicine. And even newer research promises to let men with diseases that cause impotence actually prevent sexual problems, said Dr. Jeremy Heaton of Canada's Queens University in Ontario. "We are getting into very sophisticated therapies," he said. By LAURAN NEERGAARD, AP Medical Writer Copyright 1997 Nando.net Copyright 1997 The Associated Press <http://www.nando.net/newsroom/ntn/health/102797/health15_10788_noframes.html> ----------------------------------------------------------------------- janet paterson - 50/9 - sinemet/selegiline/prozac - [log in to unmask]