Depression, antidepressant therapies, and erectile dysfunction: clinical trials of sildenafil citrate (Viagra®) in treated and untreated patients with depression

Nurnberg, H. George; Seidman, Stuart N.; Gelenberg, Alan J.; Fava, Maurizio; Rosen, Raymond C.; Shabsigh, Ridwan

doi:10.1016/s0090-4295(02)01691-6

Cited by 64 publications

(46 citation statements)

References 51 publications

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“…All patients remained on their SRI antidepressant at full effective dose and maintained 17-item Hamilton Depression Rating Scale (HAM-D17) scores consistent with remission. These results are consistent with other double-blind, placebo-controlled trials [13][14][15][16][17][18][19][20] of PDE5i treatment efficacy for erectile dysfunction (ED) in men with ED and subthreshold depression, ED of various etiologies and concurrently taking an SRI, residual ED (i.e., ED present at MDD diagnosis that persisted following treatment of depression to remission, independent of antidepressant discontinuation), ED and untreated mild MDD, and ED with congestive heart failure or postprostatectomy and associated depressive symptoms.…”

Section: Introductionsupporting

confidence: 93%

Open-label sildenafil treatment of partial and non-responders to double-blind treatment in men with antidepressant-associated sexual dysfunction

et al. 2006

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Fifty partial and non-responders (Clinical Global Impression-Sexual Function (CGI-SF) score42), out of 76 men who completed a 6-week, double-blind, placebo-controlled trial of sildenafil treatment for serotonergic antidepressant-associated sexual dysfunction, were eligible for an additional 6-week trial of open-label sildenafil (50 mg adjustable to 100 mg) under the same protocol, with blind maintained to initial assignment. Participation (double-blind and open-label) required major depressive disorder in remission (MDD-R) and continuing antidepressant medication. Forty-three entered open-label study: 16/17 initially randomized to sildenafil (sildenafil/sildenafil) and 27/33 initially randomized to placebo (placebo/sildenafil). Thirty-five of 43 (81%) achieved full response (CGI-SFp2): placebo/sildenafil 23/27 (85%); sildenafil/sildenafil 12/16 (75%); Po0.0001 for changes and P ¼ 0.4 between groups. Secondary measures of erectile function and overall satisfaction improved in both groups (Po0.03). Hamilton Depression Rating Scale scores improved (placebo/sildenafil; Pp0.05) or remained stable (sildenafil/sildenafil). In men with MDD-R who maintained antidepressant adherence, 81% of double-blind partial and nonresponders treated with open-label sildenafil responded fully.

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Section: Introductionsupporting

confidence: 93%

Open-label sildenafil treatment of partial and non-responders to double-blind treatment in men with antidepressant-associated sexual dysfunction

et al. 2006

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“…Studies of men with erectile dysfunction and depressive symptoms (but not undergoing antidepressant treatment) also show that prescription of PDE-5 inhibitors is often accompanied by a reduction in depressive symptoms, enhanced quality of life, and improved interpersonal relationships [112][113][114] . Furthermore, preclinical studies suggest that nitric oxide activity is an important vulnerability factor in the Flinders rat depressive phenotype 115 , that passage of PDE-5 inhibitors across the blood-brain barrier can occur 116 , and that sildenafil has antidepressant-like effects after central muscarinic receptor blockade 117 .…”

Section: Management Of Treatment-induced Sexual Dysfunction In Depresmentioning

confidence: 99%

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

2018

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Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely investigated in clinical trials. Treatment-emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction.

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“…14 The occurrence of one disorder may cause, result from or exacerbate the other. 14 In a study assessing the incidence of depressive symptoms in patients with ED, men with ED were 2.6 times more likely to report depressive symptoms than those without ED.…”

Section: Erectile Dysfunction In Renal Transplant Recipientsmentioning

confidence: 99%

Prevalence and prognostic factors for erectile dysfunction in renal transplant recipients

Wong

Lawen

Kiberd

et al. 2013

CUAJ

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383ED is a common disorder in men aged 40 years and over. Prevalence of ED increases with age, with 25%, 55% and 65% of men aged 65, 75 and 80 years old, respectively, reporting the disorder. 4 In a cross-sectional study of sexual function of male kidney transplant recipients, ED was considerably more common than it was in the control population, with a prevalence of 55.7% despite the transplant recipients being younger than those in the control group. 5 In that study, age, time on dialysis, and iterative transplants were significantly and negatively related to erectile dysfunction . 5 The increased number of kidney transplants being performed in addition to the improved graft and patient survival rates has resulted in a greater number of patients with ED. 4 Thus, there is an increasing number of men experiencing a major quality of life issue. 4The literature regarding the effect of renal transplantation on patients with ED has been contradictory. In most studies, patients regain potency following renal transplant.2 However, in one longitudinal study, ED did not improve markedly after transplantation. 6 In other cases, particularly in patients who received second or subsequent transplantations, erectile function has been adversely affected by interference with penile arterial blood flow. 6 The purpose of this study was to determine the prevalence of ED at our institution in the postrenal transplant population. In addition, we compared several patient characteristics of patients in this population who had ED with those postrenal transplant patients who did not have ED. MethodsWe conducted a cross-sectional study of erectile function in male renal transplant recipiPrevalence and prognostic factors for erectile dysfunction in renal transplant recipients ORGINAL RESEARCH Abstract Introduction: The purpose of this study was to determine the prevalence of erec-

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Depression, antidepressant therapies, and erectile dysfunction: clinical trials of sildenafil citrate (Viagra®) in treated and untreated patients with depression

Cited by 64 publications

References 51 publications

Open-label sildenafil treatment of partial and non-responders to double-blind treatment in men with antidepressant-associated sexual dysfunction

Open-label sildenafil treatment of partial and non-responders to double-blind treatment in men with antidepressant-associated sexual dysfunction

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

Prevalence and prognostic factors for erectile dysfunction in renal transplant recipients

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