Clinical Question:
Is Sildenafil citrate (VIAGRA and ANDROS) safe and effective in the
treatment of antipsychotic-induced erectile dysfunction?
Bottom Line:
Sildenafil citrate is safe and effective in the treatment of
antipsychotic-induced erectile dysfunction. It is also well tolerated.
Reference:
Sildenafil in the treatment of antipsychotic-induced erectile dysfunction: a
randomized, double-blind, placebo-controlled, flexible-dose, two-way
crossover trial.Gopalakrishnan R, Jacob KS, Kuruvilla A, Vasantharaj B, John
JK.: Am J Psychiatry. 2006 Mar;163(3):494-9.
Study Design:
Randomized, double-blind, placebo-controlled, flexible-dose, two-way
crossover trial
Synopsis:
Antipsychotic-induced erectile dysfunction is a significant clinical problem
and is a common reason for poor medication compliance. This report studied
the efficacy and tolerability of sildenafil citrate in patients with
antipsychotic-induced erectile dysfunction. The study design was a
randomized, double-blind, placebo-controlled, flexible-dose, two-way
crossover trial carried out at a tertiary referral center. Thirty-two
married male outpatients with schizophrenia or delusional disorder and
antipsychotic-induced erectile dysfunction were recruited for the trial.
Sexual function was assessed from patient logs of sexual activity.
Thirty-two subjects and their spouses, who agreed to take part in the study,
were included in the crossover trial. Thirty-one (96.9%) completed the
trial. There was no significant period effect or treatment-period
interaction. Patients reported significant improvement while taking
sildenafil in the number of adequate erections, satisfaction with sexual
intercourse, and the duration of erections over 2 weeks. The odds ratios for
adequate erections and for satisfactory sexual intercourse with sildenafil
were 4.07 and 3.77, respectively. The effect of sildenafil remained
significant even after adjustment for period and week effects and
treatment-period interaction with Poisson regression analysis. There were no
major side effects or adverse drug interactions. |