⚠️ Risks of dapoxetine spain discontinuation: Forcing patients to stop antidepressants can lead to relapse, withdrawal symptoms, and suicidal ideation — all before entering a psychologically open and vulnerable state.

  • Pharmaceutical companies are not actively developing a combo pill due to safety concerns.
  • Compounding pharmacies can create a custom single pill, but this is rare and regulated.
  • The stability of a compounded combination product has not been thoroughly tested.
  • Patients should be wary of any source offering a single pill containing both drugs.
  • Regulatory agencies like the FDA issue warnings about such unapproved products.
  • The chemical structures of dapoxetine and sildenafil are not similar.
  • They are metabolized by some of the same enzymes in the liver.
  • This shared metabolic pathway is the basis for their pharmacokinetic interaction.
  • Genetic polymorphisms can make some people "poor metabolizers," increasing risk.
  • Therapeutic drug monitoring is not practical for these on-demand medications.
  • The treatment is considered successful if it allows for satisfactory sexual intercourse.

In other words: the “washout” phase may do more harm than the drug combination itself. 🌱 The takeaway: Continuing antidepressants during entheogen-assisted therapy may actually increase accessibility and safety for millions who currently can’t participate in research or treatment. This isn’t just a pharmacological question — it’s an ethical one.

Sildenafil Citrate + Dapoxetine HCl DC Grade

This research underscores the adaptability of human biology and the need for healthcare providers to consider both shared and unique health risks in transgender women. To view or add a comment, sign in Recent research demonstrates that gender-affirming hormone therapy can significantly alter blood protein profiles in transgender women, aligning sildenafil dapoxetine tablets them more closely with those of cisgender women. To view or add a comment, sign in Here’s what research shows: 🔹 Key Study: A large 2016 study published in European Urology (by researchers from Harvard University) followed more than 30,000 men for almost two decades. They found that: • Men who ejaculated 21 or more times per month had about a 20% lower risk of developing prostate cancer than those who ejaculated 4–7 times per month. 🔹 What counts: Ejaculation frequency includes sex with a partner, masturbation, or nocturnal emissions.

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🔹 Why it may help: More frequent ejaculation may help clear potentially harmful substances from the prostate and reduce inflammation, though the exact biological reason is still being studied. 🔹 Important context: • It’s not a prescription — just a correlation, not proof of cause and effect. • Overall lifestyle (diet, exercise, weight, and not smoking) also strongly affects prostate health. • Men should still get regular prostate screenings as recommended by their doctor. ✅ Summary: Research suggests that around 21 ejaculations per month (roughly 4–5 times per week) is associated with the lowest risk of prostate cancer in men, compared with lower frequencies. If the future of mental health care is truly integrative, it must balance neurobiology with compassion, and clinical safety with real-world inclusion.

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Rigorous, trauma-informed trials that investigate how antidepressants modulate neuroplastic and subjective mechanisms of entheogenic therapy — without retraumatizing those who rely on them daily.

Cơ chế hoạt động

Research suggests that women with PMDD may have an altered sensitivity or function of these receptors. Changes in the specific subunits that make up the GABA−A receptor could lead to a dysfunctional response to allopregnanolone. Instead of the usual inhibitory effect, it might lead to excitation or a lack of inhibition, triggering the emotional dysregulation seen in PMDD. This is supported by the efficacy of treatments that suppress ovulation or directly block progesterone metabolites. Allopregnanolone in premenstrual dysphoric disorder: why are some women sensitive?

ATC (Anatomical Therapeutic Chemical Classification)

Antagonist action of progesterone at σ-receptors in the modulation of voltage-gated sodium channels. The Journal of Biological Chemistry, 286(9), 6825–6838.) To view or add a comment, sign in The Complexities of MHT/HRT in Neuro-Immune Illness As an Endocrinologist, I frequently manage the care of women with complex neuro-immune conditions—including Dysautonomia, POTS, #MyalgicEncephalomyelitis #MECFS, #SORSHOT (Syndrome of Residual Symptoms of Hypothyroidism on T4), and #MCAS. The Journal of Biological Chemistry, 286(9), 6825–6838.) To view or add a comment, sign in Recent research demonstrates that gender-affirming hormone therapy can significantly alter blood protein profiles in transgender women, aligning them more closely with those of cisgender women. These changes may influence susceptibility to certain health conditions, including autoimmune diseases and heart disease. The findings highlight the importance of nuanced, long-term health monitoring and suggest that personalized treatment approaches could enhance care for individuals undergoing hormone therapy. Because healing shouldn’t require withdrawal to begin. #MentalHealth #Entheogens #DepressionTreatment #Neuroplasticity #antidepressants #pharmaceuticals To view or add a comment, sign in 💊 Should patients really stop antidepressants before entheogen therapy? To view or add a comment, sign in Collaborence is the signature conference of the Psilocybin Assisted Therapy Association, a national nonprofit dedicated to advancing education, collaboration, and innovation in the world of psilocybin-assisted therapy.

Further information

To view or add a comment, sign in ICD-10-CM Diagnosis Code Updates Total changes: 252 new codes, 36 deletions, 13 revisions Notable additions by chapter: Chapter 2 (Neoplasms): New codes for Hodgkin lymphoma in remission (e.g., C81.0A–C81.9A) Chapter 4 (Endocrine): Presymptomatic Type 1 diabetes (E10.A-), new obesity classifications (E66.811–E66.813), and MC4R pathway-related obesity (E88.82) Chapter 5 (Mental Disorders): Expanded eating disorder codes including anorexia nervosa subtypes, binge eating disorder, pica, and rumination disorder in adults Chapter 6 (Nervous System): New epilepsy codes (e.g., G40.84 for KCNQ2-related epilepsy), serotonin syndrome (G90.81), and developmental encephalopathy (G93.45) Chapter 9 (Circulatory System): Expanded pulmonary embolism codes (I26.03–I26.96) Chapter 10 (Respiratory System): New codes for nasal valve collapse under acute bronchiolitis (J21) 🛠️ ICD-10-PCS Procedure Code Updates These updates also take effect October 1, 2025, and apply to inpatient procedures through September 30, 2026. To view or add a comment, sign in 💊 Should patients really stop antidepressants before entheogen therapy? A new 2025 review challenges one of the field’s most rigid assumptions. For decades, clinical trials with psilocybin, LSD, and DMT have required participants to discontinue antidepressants (SSRIs, SNRIs, MAOIs, etc.) weeks before an entheogen session. To “avoid serotonin syndrome” and “preserve the full psychedelic experience.” But the latest scoping review by Tap et al.

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(2025, Journal of Psychopharmacology) suggests this protocol may be both outdated and harmful. After analyzing 19 human studies across psilocybin, LSD, DMT, and ayahuasca, the authors found that: 🧠 Safety: There’s no robust evidence that taking antidepressants with classic entheogens increases the risk of serotonin toxicity — particularly with psilocybin. Most side effects (headache, mild nausea, temporary increases in blood pressure) were comparable to placebo. 💫 Efficacy: Even when antidepressants slightly blunted the intensity of the entheogenic experience, the therapeutic outcomes for depression and anxiety remained significant. In some studies, patients on antidepressants improved as much or more than those who discontinued them. Designed for both professionals and the public, this event brings together leading voices in mental health, psychedelic research, and community advocacy to share evidence-based insights and diverse perspectives.

Condition Dapoxetin Sildenafil
Cardiovascular disease Use cautiously Contraindicated with nitrates
Use with MAO inhibitors Avoid Avoid
Liver impairment Dose adjustment required Use with caution
Eye Disorders (e.g., retinitis pigmentosa) No specific caution Caution due to rare visual disturbances
Medication interactions Serotonergic drugs may increase risk of serotonin syndrome Other vasodilators or antihypertensives

Through panels, discussions, and networking, attendees are empowered to make informed decisions about the role of psilocybin in their personal and professional lives, while fostering connections that build stronger, more collaborative communities. Happening October 4-5, 2025, day one of The Collaborence offers online training and connection, and day two will feature two in-person expos: one in Portland, Oregon and one in Boulder, Colorado.

  • The economic burden of untreated sexual dysfunction can be significant.
  • It can lead to relationship breakdown, anxiety, and depression.
  • Effective treatment can improve overall mental health and well-being.
  • The cost of medication must be weighed against these potential benefits.
  • Patient assistance programs may be available for those who cannot afford treatment.
  • The global market for ED and PE medications is vast and highly profitable.
  • This commercial interest drives both innovation and questionable marketing practices.
  • Patients should rely on information from unbiased medical sources.
  • Websites of national health services or medical associations are reliable.
  • Forums and social media can spread misinformation and should be used cautiously.
  • The decision to treat should be based on medical need, not commercial pressure.

Be sure to check out Psychedelic Pharmacists Association members at: Day 1 October 4th Online 12:55pm – 1:40pm Psychedelics as Medicine: The Pharmacist’s Perspective Colby Burns, PharmD, MBA; April Huynh; Lauren Blue, PharmD, MS. ; Andy Krut; and Anne M Berg will explore the pharmacist’s role in evaluating and supporting psilocybin use for patients with complex comorbidities. Participants will walk away understanding: 💊 Key pharmacologic considerations, including psilocybin’s absorption, distribution, metabolism, excretion, and toxicity (ADMET), along with risks of combining psilocybin with other psychoactive or prescription substances.

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To view or add a comment, sign in 𝐆𝐋𝐏-1 𝐓𝐡𝐞𝐫𝐚𝐩𝐞𝐮𝐭𝐢𝐜𝐬 𝐚𝐧𝐝 𝐓𝐡𝐞𝐢𝐫 𝐄𝐦𝐞𝐫𝐠𝐢𝐧𝐠 𝐑𝐨𝐥𝐞 𝐢𝐧 𝐀𝐥𝐜𝐨𝐡𝐨𝐥 𝐚𝐧𝐝 𝐒𝐮𝐛𝐬𝐭𝐚𝐧𝐜𝐞 𝐔𝐬𝐞 𝐃𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬: 𝐀𝐧 𝐄𝐧𝐝𝐨𝐜𝐫𝐢𝐧𝐨𝐥𝐨𝐠𝐲 𝐏𝐫𝐢𝐦𝐞𝐫 Very interesting review just published in The Journal of the Endocrine Society by Nirupam Srinivasan and colleagues. ✍Alcohol and other substance use disorders (ASUDs) are complex, multifaceted, but treatable medical conditions with widespread medical, psychological, and societal consequences. ✍However, treatment options remain limited, therefore the discovery and development of new treatments for ASUDs is critical. ✍Glucagon-like peptide-1 receptor agonists (GLP-1RAs), currently approved for the treatment of type 2 diabetes mellitus, obesity, and obstructive sleep apnea, have recently emerged as potential new pharmacotherapies for ASUDs. ✍Following an overview of the epidemiology, biology, consequences, and treatments of ASUDs, this review provides a summary of the emerging role of GLP-1RAs in the treatment of ASUDs by elucidating their interactions with various neurobiological pathways involved in addiction.

Molecular Weight

✍It also highlights existing gaps in research, future directions, and broader implications related to the potential use of GLP-1RAs for addiction treatment. 🤓 Very interesting dapoxetine over counter topic and well written paper 🤓Most of the times we talk about alcohol addiction and GLP-1RAs, however the topic si much broader. 🤓 Preclinical studies have consistently demonstrated the potential of GLP-1RAs in reducing the consumption and rewarding properties of alcohol, opioids, nicotine, and psychostimulants. 🤓Clinical studies remain limited for most substances but early results show reductions in cravings, substance use, and other related outcomes. Definitely worth reading!👍👏😀 To view or add a comment, sign in 𝐆𝐋𝐏-1 𝐓𝐡𝐞𝐫𝐚𝐩𝐞𝐮𝐭𝐢𝐜𝐬 𝐚𝐧𝐝 𝐓𝐡𝐞𝐢𝐫 𝐄𝐦𝐞𝐫𝐠𝐢𝐧𝐠 𝐑𝐨𝐥𝐞 𝐢𝐧 𝐀𝐥𝐜𝐨𝐡𝐨𝐥 𝐚𝐧𝐝 𝐒𝐮𝐛𝐬𝐭𝐚𝐧𝐜𝐞 𝐔𝐬𝐞 𝐃𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬: 𝐀𝐧 𝐄𝐧𝐝𝐨𝐜𝐫𝐢𝐧𝐨𝐥𝐨𝐠𝐲 𝐏𝐫𝐢𝐦𝐞𝐫 Very interesting review just published in The Journal of the Endocrine Society by Nirupam Srinivasan and colleagues.

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Dr. med. Fabienne Gretener

Werdegang

Januar 2024 bis heute
Oberärztin SenoMed AG
Schwerpunktsweiterbildung gynäkologische Senology

März 2023 – Dezember 2023
Oberärztin, SenoMed AG Bern 20%

Januar 2023 – November 2023
Assistenzärztin Psychiatrie, Klinik Meissenberg Zug

Januar 2021 – November 2022
Assistenzärztin Gynecology und Geburtshilfe, Bürgerspital Solothurn

November 2019 – Oktober 2020
Assistenzärztin Gynecology und Geburtshilfe, Kantonsspital Aarau

Januar 2017 – Juli 2019
Assistenzärztin Gynecology und Geburtshilfe, Kantonsspital Olten

Paul Laszlo Bernhard

Werdegang

Jan 2024 bis heute
Facharzt SenoMed AG – Brustzentrum Bern Biel

Aug 2019 – Dez 2023
Oberarzt Frauenklinik und Brustzentrum Bürgerspital, Solothurn, Schwerpunktweiterbildung operative Gynecology und Geburtshilfe sowie Senology

Mai 2019 Facharzttitel Gynecology & Geburtshilfe

Apr 2016 – Jul 2019
Arzt in Weiterbildung, Inselspital Bern, Universitätsklinik für Frauenheilkunde

Dez 2014 – Apr 2016
Arzt in Weiterbildung, Kantonsspital Baden

Sep 2012 – Sep 2014
Arzt in Weiterbildung, Universitätsklinikum Carl Gustav Carus, Dresden

Feb 2012 – Sep 2012
Arzt in Weiterbildung, Universitätsfrauenklinik Leipzig

Nov 2011 Approbation zum Arzt

2005 – 2011
Studium der Humanmedizin an der Charité, Universitätsmedizin Berlin

Dr. med. Patrizia Sager

Werdegang

Okt 2023 bis heute
Leiterin Weiterbildungsstätte gynäkologische Senology

Feb 2018 – bis heute
Leiterin Brustzentrum Bern Biel
Practiceinhaberin SenoMed AG

Nov 2017 – bis heute
Belegärztin Salem-Spital Bern

Jan 2013 – Okt 2017
Leitung Senology Brustzentrum Frauenklinik Universitätsspital Insel, Bern

Jan 2012 – Dez 2012
Oberärztin Gynecology / Geburtshilfe, Frauenklinik Universitätsspital Insel, Bern

Nov 2010 – Dez 2011
Leitende Ärztin Gynecology und Geburtshilfe, Frauenklinik Rheinfelden (DE)

Nov 2009 – Okt 2010
Oberärztin Gynecology und Geburtshilfe, Kantonsspital Liestal

Jan 2009 – Okt 2009
Oberärztin i.V. Gynecology und Geburtshilfe, Regionalspital Interlaken

Jun 2008 – Dez 2008
Assistenzärztin Gynecology und Geburtshilfe, Regionalspital Interlaken

Aug 2007 – Mai 2008
Assistenzärztin Gynecology und Geburtshilfe, Universitätsspital Zürich

Feb 2007 – Jun 2007
Oberärztin Gynecology und Geburtshilfe, Universitätsspital Groote Schuur, Kapstadt, Südafrika

Jan 2004 – Dez 2006
Assistenzärztin Gynecology und Geburtshilfe, Regionalspital Thun

Jan 2003 – Dez 2003
Assistenzärztin Chirurgie und Orthopädie, Regionalspital Thun

Schulen, Studium & Diplome

2023
Schwerpunkt gynäkologische Senology

2014
Diplom Senology SGGG

2013
Diplom Senology: European Academy of Senology

2010
FMH Gynecology und Geburtshilfe inkl. Schwerpunkt operative Gynecology

2003
Promotion

2002
Staatsexamen in Humanmedizin

1996 – 2002
Humanmedizinstudium Universitätsspital Basel

Mitglied- und Partnerschaften

  • Schweizerische Gesellschaft für Gynecology und Geburtshilfe SGGG
  • Schweizerische Gesellschaft für Senology SGS
  • Mitglieder Arbeitsgemeinschaft Gynäkologische Onkologie AGO, Schweiz
  • European Academy of Senology EAoS
  • SAKK Project-Group breast cancer
  • Schweizerische Gesellschaft für Ultraschall in der Medizin SGUM
  • Verbindung der Schweizer Ärzte und Ärztinnen FMH
  • Society of women in senology SWIS
  • Vorstandsmitglied Ärztenetzwerk Bern