Differential Diagnosis for Loss of Libido
- Single Most Likely Diagnosis + A. Canabinoid receptor: The patient's daily use of marijuana (2x a day) is the most likely cause of his loss of libido. Marijuana's active ingredient, THC, affects the cannabinoid receptors in the brain, which can lead to decreased libido.
- Other Likely Diagnoses + C. Nicotine: Although the patient only smokes occasionally, nicotine can still have a negative impact on libido. However, the effect of nicotine on libido is generally less significant compared to the daily use of marijuana. + B. 5 alpha reductase receptor: While 5 alpha reductase inhibitors (e.g., finasteride) can cause loss of libido, the patient's normal testosterone levels and lack of mention of using such medications make this a less likely cause.
- Do Not Miss Diagnoses + D. Gaba receptor: Although GABA receptors are not typically directly associated with loss of libido, certain medications that affect GABA receptors (e.g., benzodiazepines) can have this side effect. It's essential to consider other potential causes, including medications not mentioned in the scenario.
- Rare Diagnoses + Other potential causes of loss of libido, such as hypogonadism (ruled out by normal testosterone levels), pituitary or thyroid disorders, or certain medications (e.g., SSRIs, antipsychotics), are not mentioned in the scenario and are therefore considered rare or less likely in this case. However, a comprehensive evaluation would still consider these possibilities.