Treatment of psychogenic mix ED and PME is highly problematical assignment. Two disorders have paradoxical relation .Treatment of PME aggravates ED and vice versa. Thanks to knowledge of neurotransmitters and receptors it is possible to conceive properties of an ideal drug acting both ways. A drug which is agonist for 5HT2C and D2 can be effective for mix ED and PME syndrome. There can be other alternative combination.
Electronic search was made at various database websites to find out medicines used for ED and PME using key words dopamine and serotonin agonist, alpha blocker, alpha blocker and serotonin agonist, opiod and dopamine agonist, alpha blocker and dopamine agonist. This was followed by study of journals and books describing neurochemical mechanism of erection and orgasm.
Search did not reveal many studies dealing conjoint problem of ED and PME. No single drug claimed effectiveness for mix ED and PME syndrome. Theoretically codergocrine ,phentolamine, prozacine, MDMA, lasuride, trazodone and opium is worth consideration.
Transition from PME to ED is not uncommon phenomenon. In most of cases major depression also supervene which contribute to erectile dysfunction. Combinations’ like adding apomorphine or PDE5 to SSRI, s are being used. Work is needed to evaluate, efficacy of medicines with dual mode of action. Dose adjustments are required when these drugs are to be used for sexual dysfunctions.
Prior to development f hybrid molecule for mix ED and PME previously existing drugs effecting on sexual functions need to be tested