Effects of moclobemide on sexual performance and nocturnal erections in psychogenic erectile dysfunction

Rationale and objectives: We tested the hypothesis that the selective rever sible MAO-A inhibitor moclobemide has a specific therapeutic effect on erec tile dysfunction independent of its antidepressive properties. Methods: In a double-blind placebo controlled study, 12 male outpatients suffering from psychogenic erectile dysfunction without any other psychiatric disorder we re investigated. Based on comprehensive diagnosis before the beginning of t he study, organic factors relevant for sexual function were excluded. The t reatment period was 8 weeks. Half the patients received 450 mg moclobemide during the first week, and 600 mg afterwards: the others received placebo. Apart from assessment of erectile function by means of the Clinical Global Impression (CGI) scale, nocturnal erections were measured under polysomnogr aphic control at baseline and at the end of the treatment period. Results: The evaluation of the CGI scale revealed a clearly stronger improvement und er moclobemide compared to placebo during the study period. The therapeutic efficacy found on the subjective level had no clear correlate on the neuro physiological level. No alterations of nocturnal erectile parameters were o bvious under treatment, neither were clinically relevant alterations found regarding sleep EEG parameters. The medication was well tolerated without s erious adverse events. Conclusions: The findings support the hypothesis tha t moclobemide has a specific effect on erectile dysfunction. Thus, patients suffering from psychogenic erectile dysfunction who are not depressed migh t benefit from moclobemide without relevant side effects.