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Here is an interesting product, and one that answers where the myth about yohimbe containing methyl-test came from....
*yohimbe never did contain methyltest - it was just presumed so cos at least one manufacturer mixed it with methyltest...
PROWESS
SUMMARY SHEET
--------------------------------------------------------------------------------
TRADE NAME: N/a
Prowess tablets and capsules are UNLICENSED IN THE UK.
Indications:
‘The management of cases of failure of sexual desire and functioning. Indicated in the treatment of diminished libido and impaired sexual function especially psychogenic, secondary male erectile impotence.’1,2
Active Constituents
Prowess Plain tablets: Yohimbine hydrochloride 5mg1
Prowess capsules: Yohimbine hydrochloride 5mg
Pemoline 10 mg
Methyltestosterone 5 mg2
Background
Disorders of sexual function in men and women may be primary or secondary, generalised or limited to certain situations, total or partial. The aetiological factors for both primary and secondary dysfunction can be similar and relate to psychological factors, physical factors or interpersonal and situational causes.3
The treatment options employed depend on the disorder and its likely cause. Prowess is the only medication available on prescription claimed to manage cases of failure of sexual desire and functioning in men and women.3
Clinical Efficacy
There are no published clinical trials with Prowess capsules or Prowess Plain tablets. A number of studies have investigated the efficacy of yohimbine alone in the treatment of patients with impotence. Improvements with yohimbine have been recorded in 34% to 62% of treated men. The improvements seen were not consistent and can only be considered to be modest.4,5,6,7
Trials with methyltestosterone are lacking other than in the treatment of impotence or impaired spermatogenesis with associated hypogonadism. Trials with pemoline treatment for impaired sexual desire and functioning are also lacking.8
Two combined preparations Afrodex (methyltestosterone 5mg, yohimbine hydrochloride 5mg and nux vomica extract) and Potensan Forte (methyltestosterone 5mg, yohimbine hydrochloride 5mg, strychnine 0.5mg and pemoline 10mg) were available in the 1960s and 70s for the treatment of impotent men. A review of Afrodex concluded that there was no good evidence that this product had more than placebo effects.9
An 8 week double-blind, crossover trial compared Potensan Forte 6 capsules daily with placebo treatment in impotent men. A statistically significant increase in the frequency of coital attempts was seen with treatment with a trend towards improved erections. The improvement seen was considered to be non-specific and relate to the non-steroidal components of Potensan Forte, especially the CNS stimulants pemoline and strychnine.10
Adverse Effects
Yohimbine
Common side effects include dizziness, anxiety, nervousness, insomnia, nausea, headaches, muscle cramps, increased heart rate, blood pressure and orthostatic hypotension. Yohimbine has been reported to cause manic reactions.11,12
Methyltestosterone
Oedema, hypercalaemia, impaired glucose tolerance, increased bone growth and skeletal weight, increased LDL cholesterol, decreased HDL cholesterol, increased haematocrit, and increased fibrinolytic activity, abnormal liver function tests and hepatotoxicity. In women, methyltestosterone suppresses ovarian activity and menstruation. Over the long term it has masculising effects.11
Pemoline
Overstimulation can result in insomnia, night terrors, nervousness, restlessness, irritability and euphoria followed by fatigue and depression. A number of gastrointestinal disturbances have also been reported with treatment. Convulsions, tachycardia, palpitations and increased blood pressure may occur with chronic use. Impaired liver function can develop. Pemoline is contra-indicated in patients with liver disorders. Rarely, chorea, tics, mania and neutropenia have been reported.8,11
Health Economic Considerations
No data are available on the health economics associated with Prowess treatment. At current prices one month’s treatment lies in the range £16.80 - £42 depending on the formulation and dosage selected.
Conclusion
There is no published data to support the use of Prowess capsules. Small trials of short duration have assessed the efficacy of yohimbine in the treatment of male impotence. These suggest that yohimbine may have a modest effect. However the results seen were not consistent. Data on efficacy in other sexual disorders are lacking for both these preparations.
References
Anon. Prowess Tablets. Information Sheet. Harley Street Supplies Ltd. London, UK.
Anon. Prowess Capsules. Information Sheet. Harley Street Supplies Ltd. London, UK.
Berkow R (Ed). Merck Manual of Diagnosis and Therapy. 16th Edition. Merck Research Labs. Rahway, USA. 1992.
Riley AJ, Goodman RE, Kellett JM & Orr R. Double-blind Trial of Yohimbine Hydrochloride in the Treatment of Erection Inadequacy. Sexual and Marital Therapy. 1989; 4: 17-26.
Reid K, Morales A, Harris C, Surridge DHC, Condra M, Owen J & Fenemore J. Double-blind Trial of Yohimbine in Treatment of Psychogenic Impotence. Lancet 1987; ii: 421-423
Morales A, Condra M, Owen JA, Surridge DH, Fenemore J & Harris C. Is Yohimbine Effective in the Treatment of Organic Impotence? Results of a Controlled Trial. J.Urol. 1987; 137: 1168-1172.
Susset JG, Tessier CD, Wincze J, Bensal S, Malhotra C & Schwacha MG. Effect of Yohimbine Hydrochloride on Erectile Impotence: A Double-blind Study. J.Urol. 1989; 141: 1360-1363.
Anon. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. 1996: 31.
Anon. Afrodex and Impotence. The Medical Letter on Drugs and Therapeutics 1968; 10: 97-98.
Cooper AJ, Smith CG, Ismail AAA, Loraine JA. A Controlled Trial of Potensan Forte (‘Aphrodisiac and testosterone combined’) in Impotence. Irish Journal of Medical Science 1973; 14: 155-161.
Reynolds JEF (Ed). Martindale the Extra Pharmacopoeia. 31st Edition. Royal Pharmaceutical Society. London, UK. 1996.
Montorsi F, Guazzani G, Rigatti P & Pozza G. Pharmacological Management of Erectile Dysfunction. Drugs 1995; 50: 465-479.
*yohimbe never did contain methyltest - it was just presumed so cos at least one manufacturer mixed it with methyltest...
PROWESS
SUMMARY SHEET
--------------------------------------------------------------------------------
TRADE NAME: N/a
Prowess tablets and capsules are UNLICENSED IN THE UK.
Indications:
‘The management of cases of failure of sexual desire and functioning. Indicated in the treatment of diminished libido and impaired sexual function especially psychogenic, secondary male erectile impotence.’1,2
Active Constituents
Prowess Plain tablets: Yohimbine hydrochloride 5mg1
Prowess capsules: Yohimbine hydrochloride 5mg
Pemoline 10 mg
Methyltestosterone 5 mg2
Background
Disorders of sexual function in men and women may be primary or secondary, generalised or limited to certain situations, total or partial. The aetiological factors for both primary and secondary dysfunction can be similar and relate to psychological factors, physical factors or interpersonal and situational causes.3
The treatment options employed depend on the disorder and its likely cause. Prowess is the only medication available on prescription claimed to manage cases of failure of sexual desire and functioning in men and women.3
Clinical Efficacy
There are no published clinical trials with Prowess capsules or Prowess Plain tablets. A number of studies have investigated the efficacy of yohimbine alone in the treatment of patients with impotence. Improvements with yohimbine have been recorded in 34% to 62% of treated men. The improvements seen were not consistent and can only be considered to be modest.4,5,6,7
Trials with methyltestosterone are lacking other than in the treatment of impotence or impaired spermatogenesis with associated hypogonadism. Trials with pemoline treatment for impaired sexual desire and functioning are also lacking.8
Two combined preparations Afrodex (methyltestosterone 5mg, yohimbine hydrochloride 5mg and nux vomica extract) and Potensan Forte (methyltestosterone 5mg, yohimbine hydrochloride 5mg, strychnine 0.5mg and pemoline 10mg) were available in the 1960s and 70s for the treatment of impotent men. A review of Afrodex concluded that there was no good evidence that this product had more than placebo effects.9
An 8 week double-blind, crossover trial compared Potensan Forte 6 capsules daily with placebo treatment in impotent men. A statistically significant increase in the frequency of coital attempts was seen with treatment with a trend towards improved erections. The improvement seen was considered to be non-specific and relate to the non-steroidal components of Potensan Forte, especially the CNS stimulants pemoline and strychnine.10
Adverse Effects
Yohimbine
Common side effects include dizziness, anxiety, nervousness, insomnia, nausea, headaches, muscle cramps, increased heart rate, blood pressure and orthostatic hypotension. Yohimbine has been reported to cause manic reactions.11,12
Methyltestosterone
Oedema, hypercalaemia, impaired glucose tolerance, increased bone growth and skeletal weight, increased LDL cholesterol, decreased HDL cholesterol, increased haematocrit, and increased fibrinolytic activity, abnormal liver function tests and hepatotoxicity. In women, methyltestosterone suppresses ovarian activity and menstruation. Over the long term it has masculising effects.11
Pemoline
Overstimulation can result in insomnia, night terrors, nervousness, restlessness, irritability and euphoria followed by fatigue and depression. A number of gastrointestinal disturbances have also been reported with treatment. Convulsions, tachycardia, palpitations and increased blood pressure may occur with chronic use. Impaired liver function can develop. Pemoline is contra-indicated in patients with liver disorders. Rarely, chorea, tics, mania and neutropenia have been reported.8,11
Health Economic Considerations
No data are available on the health economics associated with Prowess treatment. At current prices one month’s treatment lies in the range £16.80 - £42 depending on the formulation and dosage selected.
Conclusion
There is no published data to support the use of Prowess capsules. Small trials of short duration have assessed the efficacy of yohimbine in the treatment of male impotence. These suggest that yohimbine may have a modest effect. However the results seen were not consistent. Data on efficacy in other sexual disorders are lacking for both these preparations.
References
Anon. Prowess Tablets. Information Sheet. Harley Street Supplies Ltd. London, UK.
Anon. Prowess Capsules. Information Sheet. Harley Street Supplies Ltd. London, UK.
Berkow R (Ed). Merck Manual of Diagnosis and Therapy. 16th Edition. Merck Research Labs. Rahway, USA. 1992.
Riley AJ, Goodman RE, Kellett JM & Orr R. Double-blind Trial of Yohimbine Hydrochloride in the Treatment of Erection Inadequacy. Sexual and Marital Therapy. 1989; 4: 17-26.
Reid K, Morales A, Harris C, Surridge DHC, Condra M, Owen J & Fenemore J. Double-blind Trial of Yohimbine in Treatment of Psychogenic Impotence. Lancet 1987; ii: 421-423
Morales A, Condra M, Owen JA, Surridge DH, Fenemore J & Harris C. Is Yohimbine Effective in the Treatment of Organic Impotence? Results of a Controlled Trial. J.Urol. 1987; 137: 1168-1172.
Susset JG, Tessier CD, Wincze J, Bensal S, Malhotra C & Schwacha MG. Effect of Yohimbine Hydrochloride on Erectile Impotence: A Double-blind Study. J.Urol. 1989; 141: 1360-1363.
Anon. British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britain. 1996: 31.
Anon. Afrodex and Impotence. The Medical Letter on Drugs and Therapeutics 1968; 10: 97-98.
Cooper AJ, Smith CG, Ismail AAA, Loraine JA. A Controlled Trial of Potensan Forte (‘Aphrodisiac and testosterone combined’) in Impotence. Irish Journal of Medical Science 1973; 14: 155-161.
Reynolds JEF (Ed). Martindale the Extra Pharmacopoeia. 31st Edition. Royal Pharmaceutical Society. London, UK. 1996.
Montorsi F, Guazzani G, Rigatti P & Pozza G. Pharmacological Management of Erectile Dysfunction. Drugs 1995; 50: 465-479.
