AN OPEN TRIAL OF ORAL SILDENAFIL IN ANTIDEPRESSANT-INDUCED SEXUAL DYSFUNCTION

Background: Sildenafil is a selective inhibitor of cyclic GMP-specific phosphodiesterase type 5 that has been associated with greater improv ement of erectile function compared to placebo among men with erectile dysfunction. The goal of our study was to evaluate its efficacy in a small sample of outpatients with antidepressant-induced sexual dysfunc tion. Methods: We studied the first 14 depressed outpatients (9 men an d 5 women; mean age: 46.4 +/- 8.4) who were consecutively treated with oral sildenafil. Twelve of the 14 patients were treated with an SSRI and 2 with mirtazapine. All patients were prescribed oral sildenafil t ablets at the initial dose of 50 mg q.d. p.r.n., with the possibility of increasing the dose to 100 mg q.d. p.r.n., if clinically indicated. We administered a sexual functioning questionnaire derived from the G uided Interview Questionnaire for females and males and from the Arizo na Sexual Experience Scale to all patients before and after at least 4 weeks of treatment with oral sildenafil. The mean sildenafil dose in our 14 patients was 57 +/- 18 mg/day. Results: All 14 subjects complet ed the follow-up assessments and no subjects discontinued the drug pre maturely. We observed statistically significant improvements in all do mains of sexual functioning, including libido, arousal, orgasm, sexual satisfaction, and (in males only) erectile function, with a 69% rate of patients reporting themselves as much or very much improved. Oral s ildenafil treatment appeared to be very well tolerated, with only 1 ou t of 14 (7%) patients reporting an adverse event (hot flashes). Conclu sions: Our findings of statistically significant improvements in all d omains of sexual functioning in a sample of 14 men and women with anti depressant-induced sexual dysfunction suggest that this agent may repr esent an efficacious approach to this population.