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Use of sildenafil associated with improvement in antidepressant-related sexual dysfunction in women
July 23, 2008Women with sexual dysfunction caused by the use of antidepressants experienced a reduction in adverse sexual effects with use of sildenafil, commonly known as the erectile dysfunction medication Viagra, according to a study in the July 23/30 issue of JAMA.
Treatment-related sexual dysfunction is a frequent adverse effect occurring with medication use and is a major influence for early discontinuation of antidepressant treatment, which can lead to treatment failure. Sexual dysfunction is recognized as being associated with selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants, which are the most frequently prescribed medications for outpatients age 18 to 65 years and represent 90 percent of the 180 million antidepressant prescriptions filled in the United States, according to background information in the article.
"Antidepressant treatment-associated sexual dysfunction is estimated to occur in 30 percent to 70 percent of men and women treated for major depression with first- or second-generation agents, a principal reason for a 3-fold increased risk of nonadherence that approaches 70 percent in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilization by affected patients," the authors write. It is believed no randomized controlled trial has demonstrated an effective treatment for women experiencing sexual dysfunction associated with SRIs.
H. George Nurnberg, M.D., of the University of New Mexico School of Medicine, Albuquerque, N.M., and colleagues compared the efficacy of sildenafil against placebo for treatment of sexual dysfunction (such as orgasm delay or lack of arousal [lubrication]) associated with SRI treatment in 98 women (average age 37) with major depression in remission. The randomized controlled clinical trial was conducted between Sept. 2003 and Jan. 2007 at seven U.S. research centers. Participants were randomly assigned to take sildenafil (n = 49) or placebo (n = 49) at a flexible dose starting at 50 mg., adjustable to 100 mg., approximately one to two hours before anticipated sexual activity, for 8 weeks.
The researchers found that 73 percent of women taking placebo, compared with 28 percent of women taking sildenafil, reported no improvement with treatment. On a clinician-rated severity improvement scale, women in the sildenafil group showed greater improvement in sexual function than women in the placebo group.
Headache, flushing, and indigestion were reported frequently during treatment, but no patients withdrew because of serious adverse effects.
"These findings are important not only because women experience major depressive disorder at nearly double the rate of men and because they experience greater resulting sexual dysfunction than men but also because it establishes that selective phosphodiesterase type 5 inhibitors [such as sildenafil] are effective in both sexes for this purpose. By treating this bothersome treatment-associated adverse effect in patients who have been effectively treated for depression, but need to continue on their medication to avoid relapse or recurrence, patients can remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes," the authors write.
JAMA and Archives Journals
H. George Nurnberg, M.D., of the University of New Mexico School of Medicine, Albuquerque, N.M., and colleagues compared the efficacy of sildenafil against placebo for treatment of sexual dysfunction (such as orgasm delay or lack of arousal [lubrication]) associated with SRI treatment in 98 women (average age 37) with major depression in remission. The randomized controlled clinical trial was conducted between Sept. 2003 and Jan. 2007 at seven U.S. research centers. Participants were randomly assigned to take sildenafil (n = 49) or placebo (n = 49) at a flexible dose starting at 50 mg., adjustable to 100 mg., approximately one to two hours before anticipated sexual activity, for 8 weeks.
The researchers found that 73 percent of women taking placebo, compared with 28 percent of women taking sildenafil, reported no improvement with treatment. On a clinician-rated severity improvement scale, women in the sildenafil group showed greater improvement in sexual function than women in the placebo group.
Headache, flushing, and indigestion were reported frequently during treatment, but no patients withdrew because of serious adverse effects.
"These findings are important not only because women experience major depressive disorder at nearly double the rate of men and because they experience greater resulting sexual dysfunction than men but also because it establishes that selective phosphodiesterase type 5 inhibitors [such as sildenafil] are effective in both sexes for this purpose. By treating this bothersome treatment-associated adverse effect in patients who have been effectively treated for depression, but need to continue on their medication to avoid relapse or recurrence, patients can remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes," the authors write.
JAMA and Archives Journals
Sexual Dysfunction Current Events and Sexual Dysfunction News RSSNew recommendations by scientific societies about late-onset hypogonadism
The January issue of European Urology, the official journal of the European Association of Urology published by Elsevier, will feature new recommendations on late-onset hypogonadism (LOH), recently formulated by major scientific organizations.
Erectile dysfunction related to sleep apnea may persist, but is treatable
For sufferers of sleep apnea, erectile dysfunction (ED) is often part of the package. New research indicates that ED in cases of obstructive sleep apnea syndrome (OSAS) may be linked to the chronic intermittent hypoxia-oxygen deprivation- (CIH) that patients with OSAS experience during episodes of obstructed breathing.
Tadalafil shows promise for relief of lower urinary tract symptoms associated with BPH
Men with signs of benign prostatic hyperplasia (BPH) can be helped with a daily dose of erectile dysfunction drug tadalafil (Cialis®) to relieve associated lower urinary tract symptoms (LUTS), according to a new study published in the October 2008 issue of The Journal of Urology.
Causes for sexual dysfunction change as people age
Sexual dysfunction is not an inevitable part of aging, but it is strongly related a number of factors, such as mental and physical health, demographics and lifetime experiences, many of which are interrelated, according to a new study by researchers at the University of Chicago.
Male circumcision efforts lag in Africa despite evidence of dramatic impact in preventing HIV
With millions of lives at stake over the next two decades, researchers and advocates at the AIDS 2008 Conference today called on the global health community to ramp up male circumcision to significantly reduce risk of HIV infection in Africa, and to move quickly to integrate the life-saving procedure into other comprehensive efforts to prevent transmission of the disease in the vulnerable nations of eastern and southern Africa.
NIDDK Publishes a Strategic Plan for Research into Benign Prostate Disease
For the first time, a strategic plan for research into benign prostate disease, based on the latest scientific knowledge, has been published by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH).
Sexual dissatisfaction in postmenopausal women not linked to cardiovascular disease
Although sexual dysfunction in some men is predictive of cardiovascular disease, this association has never been examined in women.
Decreased sexual satisfaction is not associated with cardiovascular disease in postmenopausal women
Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) and collaborators nationwide have found that decreased sexual satisfaction in postmenopausal women, is not clearly associated with cardiovascular disease.
Mayo researchers look for explanation behind high incidence of diabetes among Asian Indians
The incidence of type 2 diabetes is rising, especially in urbanized parts of the world where sedentary lifestyles and obesity abound. In addition to weight and inactivity, race puts some people at increased risk for developing type 2 diabetes.
'Mismatched' prostate cancer treatment more common than expected
More than a third of men with early prostate cancer who participated in a study analyzing treatment choice received therapies that might not be appropriate, based on pre-existing problems with urinary, bowel or sexual function.
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