Hello 07191929-ga,
Atacand has been reported as causing psychiatric effects, including
anxiety, depression and somnolence in 0.5% of patients. Therefore, it
might just be associated with your depression, although this is a very
rare side effect.
HCTZ stands for hydrochlorothiazide. Dyazide is a combination of
hydrochlorothiazide and triamterene. Like pinkfreud, I think the B
was mistakenly substituted for the D in your query. Dyazide can cause
headache and fatigue, which of course could affect your general sense
of wellbeing. Also, decreased sex drive is listed as a possible side
effect.
I have found some studies in the medical literature which report
decreased libido in men taking hydrochlorothiazide – see below for
details. One study suggests that this could be due to a decrease in
body zinc levels, and that zinc supplements might possibly help in
some cases.
I did not find any further studies in the medical literature on the
psychiatric effects of Atacand (candesartan).
I did not find any evidence that these drugs interact with each other.
However, there is a very small possibility that each of them
separately could be contributing to your problem. There is also the
possibility that only one of them is reponsible, because depression
could affect the libido, and decreased libido could cause depression.
I certainly think that you are totally justified to discuss this with
your MD, especially if it is causing you concern.
Search strategy:
I looked for side effects of these drugs in the information provided
by http://www.rx.com
Atacand (generic name: candesartan)
From the Clinical Information section “Psychiatric side effects have
rarely been associated with the use of candesartan in approximately
0.5% of patients, and have included anxiety, depression, and
somnolence.”
No further relevant information in the Patient Information section.
Dyazide (generic name: hydrochlorothiazide = HCTZ)
From the Clinical Information section “Nervous system side effects
include fatigue and headache.”
From the Patient Information section: “Other, less serious side
effects may be more likely to occur. … dizziness; tingling or numbness
in your hands or feet; headache or tiredness; excessive urination;
muscle weakness or cramps; increased hunger or thirst; a dry mouth;
nausea, vomiting, diarrhea, or constipation; changes in weight;
increased swelling; skin sensitivity to sunlight; or decreased sex
drive.”
To view these statements, go to http://www.rx.com/rx.asp?n=0&i=zx and
type the name of the medication into the drug search box. Once you
reach the drug information page, you can look at side effects in the
patient information section and also in the clinical information
section.
It is also possible to search for drug interactions on Rx.com. This
did not give a positive result for a combination of Atacand and
Dyazide.
I then went into the medical literature database Medline
-http://www.ncbi.nlm.nih.gov/entrez/query.fcgi - and found the
following:
1. Annals of Pharmacotherapy 1993 Nov; Vol 27(11):1329-1332
Effect of frequently prescribed cardiovascular medications on sexual
function: a pilot study.
Kroner BA, Mulligan T, Briggs GC.
University of Pittsburgh, PA.
The authors conducted a telephone survey of 132 male patients. Among
their conclusions, they state: “Hydrochlorothiazide was associated
with decreased orgasmic ability”
A summary of the study is available at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8286802&dopt=Abstract
2. Central African Journal Medicine 1995 Oct; Vol 41(10):312-315
Zinc, hydrochlorothiazide and sexual dysfunction.
Khedun SM, Naicker T, Maharaj B.
Department of Experimental and Clinical Pharmacology, University of
Natal Medical School, Durban, South Africa.
The authors studied 39 men who were taking hydrochlorothiazide. 22
experienced sexual dysfunction and 20 had significantly decreased body
zinc levels. Zinc supplementation improved the sexual performance of 1
out of 11 men.
Summary: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8556776&dopt=Abstract
3. American Journal of Medicine 1989 Jan; Vol 86(1B):110-112
Comparative effects of prazosin and hydrochlorothiazide on sexual
function in hypertensive men.
Scharf MB, Mayleben DW.
Sleep Disorders Center of Mercy Hospital, Hamilton/Fairfield,
Cincinnati, Ohio 45246.
“Objectively, no significant changes were observed between the two
antihypertensive agents in relation to rapid eye movement-related
sleep architecture, serum testosterone levels, or penile blood flow.
Decrements in buckling pressure and subjective aspects of sexual
dysfunction were greater during hydrochlorothiazide treatment”
Summary: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2913766&dopt=Abstract
4. Hypertens Suppl 1987 Feb; Vol 5(1):S29-35 Impact of
antihypertensive therapy on quality of life: effect of
hydrochlorothiazide.
Williams GH, Croog SH, Levine S, Testa MA, Sudilovsky A.
In a study of 626 male patients, “More individuals requiring a
diuretic experienced sexual dysfunction and a substantial worsening of
their general well-being and of physical symptom indices over the 24
weeks of the study”
Summary: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3553493&dopt=Abstract |
Clarification of Answer by
tehuti-ga
on
21 Nov 2002 08:42 PST
Hello Vernon,
I have already given you the information for Dyazide as well as for
Atacand in my answer, because I was 99.99% sure it was Dyazide you
meant. Hydrochlorothiazide (shortened to HCTZ) is one of the two
drugs that is found in Dyazide. The other one is triamterene, but this
is not associated with any side effects relevant to your query so I
have not written anything about it. I have given you information about
side effects of Atacand and Dyazide as listed on www.Rx.com. In
addition, I have given you details of studies reported in medical
journals which show that hydrochlorothiazide (and therefore Dyazide)
can decrease the libido.
To summarise:
Atacand has been reported to cause psychiatric symptoms including
depression in 0.5% of patients who are given this drug.
Dyazide is reported to decrease the sex drive in males.
Decreased libido can in turn give rise to depression. Depression can
affect the libido. Therefore, either drug alone or both drugs
together could be causing your symptoms. Please note, however, that
depression is a very rare side effect of Atacand (it happens in 5 out
every 1000 people who take Atacand).
In my answer, I have given the relevant summaries of side effects of
both drugs as listed on Rx.com. I have also given you a list of
studies linking Dyazide with decreased libido. Please note that these
studies refer to hydrochlorothiazide, which is one of the constituents
of Dyazide.
Hope this helps
tehuti
|
