Sildenafil Citrate for the Management of Antidepressant-Associated Erectile Dysfunction

Sexual side effects of serotonin reuptake inhibitors, such as antidepressant-associated erectile dysfunction,are common and negatively impact treatment compliance. Current management approaches have importantlimitations, and most lack clear and meaningful efficacy in double-blind, placebo-controlled trials.A MEDLINE search (English language, 1966-2003) was performed using the terms antidepressive agents,erectile dysfunction, and sildenafil. Emphasis was placed on studies that used specific sexual function measurements and were placebo controlled. Sildenafil citrate, a selective and competitive inhibitor of phosphodiesterase type 5, enhances the cyclic guanosine monophosphate-mediated relaxation of cavernosalsmooth muscles in response to sexual stimulation, permitting vascular engorgement and penile erection.The efficacy and tolerability of sildenafil in the treatment of antidepressant-associated erectile dysfunctionhave been confirmed in double-blind, placebo-controlled trials.