Sildenafil and Antidepressant-Associated Sexual Dysfunction

Journal Watch. 2003;2(2) 


Sexual dysfunction associated with the use of serotonin reuptake inhibitors (SRIs) has been reported in 30% to 70% of treated patients and is a significant contributor to discontinuation of these medications. In a multicenter, university-based, double-blind, prospective study that was funded by the manufacturer of sildenafil, 90 antidepressant-treated men with sexual dysfunction and remitted depression were randomized to receive 6 weeks of treatment with sildenafil (50 to 100 mg) or placebo (mean age, 45; duration of antidepressant use, 27 months). Sexual dysfunction was defined as erectile problems, delayed ejaculation, or lack of orgasm. Most patients were taking an SSRI.

On standardized rating scales, significantly more sildenafil recipients than placebo recipients showed marked improvement in sexual function (55% vs. 4%); however, sildenafil had little effect on sexual desire. In both groups, scores on depression scales remained consistent with remission. Other than headache (reported by 40% of sildenafil recipients) and flushing (17%), few adverse effects were noted.

This patient group was highly selected: All participants were healthy, had no medical conditions that could impair sexual function, and had no sexual dysfunction prior to antidepressant treatment. Nevertheless, these results indicate that sexual dysfunction in at least half of these SRI-treated patients improved with sildenafil treatment.

— Gary Tucker, MD

Nurnberg HG et al. Treatment of antidepressant-associated sexual dysfunction with sildenafil: A randomized controlled trial. JAMA 2003 Jan 1; 289:56-64.

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