 |
|
Treatment of Antidepressant-Associated Sexual Dysfunction With Sildenafil
A Randomized Controlled Trial
H. George Nurnberg, MD;
Paula L. Hensley, MD;
Alan J. Gelenberg, MD;
Maurizio Fava, MD;
John Lauriello, MD;
Susan Paine, MPH
JAMA. 2003;289:56-64.
Context Sexual dysfunction is a common adverse effect of antidepressants that frequently results in treatment noncompliance.
Objective To assess the efficacy of sildenafil citrate in men with sexual dysfunction associated with the use of selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants.
Design, Setting, and Patients Prospective, parallel-group, randomized, double-blind, placebo-controlled trial conducted between November 1, 2000, and January 1, 2001, at 3 US university medical centers among 90 male outpatients (mean [SD] age, 45 [8] years) with major depression in remission and sexual dysfunction associated with SRI antidepressant treatment.
Intervention Patients were randomly assigned to take sildenafil (n = 45) or placebo (n = 45) at a flexible dose starting at 50 mg and adjustable to 100 mg before sexual activity for 6 weeks.
Main Outcome Measures The primary outcome measure was score on the Clinical Global Impression-Sexual Function (CGI-SF); secondary measures were scores on the International Index of Erectile Function, Arizona Sexual Experience Scale, Massachusetts General Hospital-Sexual Functioning Questionnaire, and Hamilton Rating Scale for Depression (HAM-D).
Results Among the 90 randomized patients, 93% (83/89) of patients treated per protocol took at least 1 dose of study drug and 85% (76/89) completed week 6 end-point assessments with last observation carried forward analyses. At a CGI-SF score of 2 or lower, 54.5% (24/44) of sildenafil compared with 4.4% (2/45) of placebo patients were much or very much improved (P<.001). Erectile function, arousal, ejaculation, orgasm, and overall satisfaction domain measures improved significantly in sildenafil compared with placebo patients. Mean depression scores remained consistent with remission (HAM-D score  10) in both groups for the study duration.
Conclusion In our study, sildenafil effectively improved erectile function and other aspects of sexual function in men with sexual dysfunction associated with the use of SRI antidepressants. These improvements may allow patients to maintain adherence with effective antidepressant treatment.
Author Affiliations: Department of Psychiatry, Health Sciences Center, University of New Mexico School of Medicine, Albuquerque (Drs Nurnberg, Hensley, and Lauriello, and Ms Paine); Department of Psychiatry, Arizona Health Sciences Center, Tucson (Dr Gelenberg); Massachusetts General Hospital, Boston (Dr Fava).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
RELATED LETTER
Sildenafil as Treatment for Antidepressant-Induced Sexual Dysfunction—Reply
H. George Nurnberg
JAMA. 2008;300(20):2365-2366.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Sildenafil as Treatment for Antidepressant-Induced Sexual Dysfunction--Reply
Nurnberg
JAMA 2008;300:2365-2366.
FULL TEXT
Incensole acetate, an incense component, elicits psychoactivity by activating TRPV3 channels in the brain
Moussaieff et al.
FASEB J. 2008;22:3024-3034.
ABSTRACT
| FULL TEXT
Sildenafil Treatment of Women With Antidepressant-Associated Sexual Dysfunction: A Randomized Controlled Trial
Nurnberg et al.
JAMA 2008;300:395-404.
ABSTRACT
| FULL TEXT
Obsessive-Compulsive Disorder: An Update for the Clinician
Koran
Focus 2007;5:299-313.
FULL TEXT
Efficacy and Tolerability of Vardenafil in Men With Mild Depression and Erectile Dysfunction: The Depression-Related Improvement With Vardenafil for Erectile Response Study
Rosen et al.
Am. J. Psychiatry 2006;163:79-87.
ABSTRACT
| FULL TEXT
A double blind, randomised study of sildenafil citrate for erectile dysfunction in men with multiple sclerosis
Fowler et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:700-705.
ABSTRACT
| FULL TEXT
Erectile Dysfunction: Evaluation and New Treatment Options
Carson
Psychosom. Med. 2004;66:664-671.
ABSTRACT
| FULL TEXT
Optimizing Response To Phosphodiesterase Therapy: Impact of Risk-Factor Management
Guay
J Androl 2003;24:S59-S62.
FULL TEXT
ADDITIONAL ARTICLES ABSTRACTED IN ACP JOURNAL CLUB
Evid. Based Med. 2003;8:131-131.
FULL TEXT
Letter to the Editor: Regarding Ejaculation, Delayed and Otherwise
J Androl 2003;24:496-496.
FULL TEXT
Assessing and Treating Sexual Dysfunction
Mahan
J Am Psychiatr Nurses Assoc 2003;9:90-95.
ABSTRACT
Sildenafil and Antidepressant-Associated Sexual Dysfunction
JWatch Psychiatry 2003;2003:1-1.
FULL TEXT
Sildenafil for Antidepressant-Associated Sexual Dysfunction
JWatch General 2003;2003:3-3.
FULL TEXT
|
