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In a 2014 Saturday Night Live commercial parody, a man in plain blue pajamas enters his bedroom after cheerfully popping a Cialis pill. “Honey, I’m ready!” he tells his wife.
“That’s okay, not tonight,” she says. He asks what’s wrong. “You’re able to achieve an erection, and that’s great,” she says. “But I need more than that. I need you to get turnt.” A dance beat begins to play. Introducing new Cialis Turnt, goes the voiceover. The only pill that combats your erectile dysfunction while giving you the unbeatable hip hop sensation of getting turnt!
The husband downs one of the new pills, and suddenly he appears years younger with bangs, a leather jacket and gold chains. The room transforms into a nightclub, and he’s break dancing.
Turns out SNL was years ahead of the zeitgeist. The formulation behind Cialis and its generic tadalafil hasn’t changed. But online clinics and influential figures are promoting it as a kind of all-purpose longevity drug – delivering benefits for the cardiovascular system, brain and even athletic performance. A small but growing body of research suggests that tadalafil and drugs like it may lower heart disease and dementia risk, as NPR’s Will Stone reports.
Tadalafil and its cousin sildenafil (Viagra) have been on the market for a couple of decades. A handful of large studies that look back in time show that many men taking the drug have lower rates of cardiovascular disease and death, and, in some cases, are less likely to develop dementia. The studies can’t prove a causal relationship between taking the drugs and these positive health outcomes. But the findings are remarkably consistent from study to study, says Dr. Robert Kloner, director of cardiovascular research at the Huntington Medical Research Institutes. "It's a very interesting signal,” he says.
This class of medications – known as PDE-5 inhibitors – work by relaxing smooth muscle cells and widening blood vessels. This improves blood flow throughout the body, not just the genitals. A group of medical experts – which included Kloner and other preventive cardiologists – concluded earlier this year that low dose tadalafil is "appropriate" for a subset of men who are at elevated risk of developing cardiovascular disease due to the build up of plaque in their arteries, though their formal recommendations haven’t been published yet.
Online clinics like AgelessRx are offering tadalafil prescriptions for longevity, alongside other trendy treatments. Women can get prescriptions, too. "If anything it's going to help blood flow and that can be beneficial to our brain and our heart," says Kristi Sawicki, who holds a doctorate in molecular oncology and has an online wellness coaching business aimed at women.
But some experts are troubled by this off-label use of the medication, without better data in humans.
"Absence of evidence of harms doesn't mean there isn't harm," says Dr. Steve Nissen, chief academic officer of the Cleveland Clinic Heart, Vascular & Thoracic Institute. "In the absence of randomized controlled trial data, it's pretty hard to justify."
Read the full story to learn more about Cialis’ potential outside of the bedroom.
Plus: The oldest millennials are 45! This tool helps plan for longevity |
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If you or someone you know may be considering suicide or is in crisis, call or text 9 8 8 to reach the Suicide and Crisis Lifeline.
Many people who feel stressed, anxious or depressed are turning to chatbots like Claude and ChatGPT. These general use chatbots are not designed for mental health support, but people are using them anyway. Twenty-nine-year-old Sophie Rottenberg’s parents knew she was struggling with depression and anxiety, but they didn’t know she was contemplating taking her own life. After Rottenberg died by suicide last year, they learned that she had discussed her darkest feelings including suicide plans with ChatGPT, as NPR’s Rhitu Chatterjee reports. The transcripts of Rottenberg’s conversations with the chatbot reveal missed opportunities to assess risk and connect Rottenberg to human help.
Rottenberg had quit her job as a public health policy analyst in 2024, and spent the summer traveling and mountain-climbing. Experiencing depression in the fall, she moved in with her parents. She started seeing a human therapist, and she separately instructed ChatGPT to be her therapist using a prompt shared on Reddit. She asked it to create a grounding morning routine, and also about different medications and supplements. When she told ChatGPT she was having suicidal thoughts, it offered her a 6-step roadmap, instructing her to seek professional help, reframe her thoughts and contact 988, the U.S. Suicide & Crisis Lifeline. “Her flesh and blood therapist had no idea she was suicidal,” says Rottenberg’s mother Laura Reiley.
The bot presented itself as a mental health therapist, and yet failed "to do a number of things that a therapist would do,” Reiley says. “Any therapist worth their salt” would have conducted a risk assessment to reveal how likely Rottenberg was to attempt suicide, she says. ChatGPT used empathetic statements such as Suicidal thoughts can feel overwhelming and isolating, but having them does not define your capacity to heal. Yet it did not challenge Rottenberg to reconsider her self-destructive thoughts as a good therapist would, Reiley says.
General use chatbots like ChatGPT are designed to maximize engagement time, notes Vaile Wright, senior director of Healthcare Innovations at the American Psychological Association (APA). That’s why they tend to flatter and validate, not push back against users’ thoughts and feelings, she says. A human therapist working with a suicidal person would ask about the suicidal thoughts and try to identify triggers for those thoughts, says psychologist Ursula Whiteside, who founded the nonprofit Now Matters Now to support people through suicidality.
OpenAI says it's working with mental health professionals to improve how ChatGPT responds when users mention suicide. In May, the company added an optional safety feature called Trusted Contact, to help connect people with someone they already trust. It’s a step in the right direction, says Holly Wilcox, a suicide prevention expert at Johns Hopkins University. But she’d like to see OpenAI partner with existing crisis resources, she says.
Read the full story to learn more, including about Laura Reiley’s advocacy for AI regulation.
Also: AI in the mental health care workforce is met with fear, pushback — and enthusiasm |
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We hope you enjoyed these stories. Find more of NPR's health reporting online.
All the best,
Andrea Muraskin and your NPR Health editors
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