Amisulpride And Fluvoxamine Combination Resulted In Sinus Bradycardia: A Case Report

@#Objective: Bradycardia due to the combination of amisulpride and fluvoxamine is not commonly known in the literature. Methods: We report a case of asymptomatic sinus bradycardia that occurred when amisulpride and fluvoxamine were given concurrently and resolved after cessation of both these two medications. The Naranjo scale for Adverse Drug Reaction was used to determine the likelihood of medications’ in causing bradycardia. Other possible causes were also assessed and ruled out through medical consultations. Results: This case strongly suggests that the bradycardia occurred due to the combined effect of these medications’ independent risk in causing this potentially harmful cardiac event. Conclusion: Therefore, it is important to monitor for bradycardia whenever both these medications are prescribed even at therapeutic dosages.

Premature Ejaculation in Urban Malaysian Population: The Associations between Erectile Dysfunction(ED), Anxiety and Depression

Both premature ejaculation(PE) and erectile dysfunction(ED) are prevalent sexual health disorders that have been inadequately investigated in Malaysia, a multiethnic and conservative nation.The objective of the study was to study the relationship between PE and ED, and other common mental health issues, i.e. anxiety and depression in Malaysian urban population. Methods: The diagnosis for PE was established by clinical diagnosis using DSM-5 and ISSM definition criteria for PE, whereas a diagnosis of ED was established by the International Index of Erectile Function (IIEF) questionnaire. Anxiety and depression levels were detected from the Hospital Anxiety and Depression Scale (HADS). Results: Based on DSM-V and ISSM clinical diagnosis for PE, the prevalence of PE was found to be 25%. Erectile dysfunction (p = 0.035, OR = 3.315, 95% CI 1.088, 10.103) and severe anxiety (p = 0.020, OR = 7.656, 95% CI 1.383, 42.396) significantly predicted presence of PE. Conclusion: There was a strong association between PE and ED and between PE and anxiety. Routine examination for PE in male patients should address the issue and the management of both ED and anxiety among PE patients, especially in an urban Malaysian clinical and medical care setting.