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Sildenafil Citrate for SSRI-Induced Sexual Side Effects

1999; American Psychiatric Association; Volume: 156; Issue: 1 Linguagem: Inglês

10.1176/ajp.156.1.156a

1535-7228

James L. Schaller, David Béhar,

Sexuality, Behavior, and Technology

Back to table of contents Previous article Next article Letters To The EditorFull AccessSildenafil Citrate for SSRI-Induced Sexual Side EffectsJAMES L. SCHALLER, M.D., M.A.R., , and DAVID BEHAR, M.D., JAMES L. SCHALLERSearch for more papers by this author, M.D., M.A.R., West Chester, Pa., and DAVID BEHARSearch for more papers by this author, M.D., Philadelphia, Pa.Published Online:1 Jan 1999https://doi.org/10.1176/ajp.156.1.156aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We present the case of a 42-year-old man with major depression who experienced remission with sertraline but suffered anorgasmia and erectile dysfunction reversed with sildenafil citrate.Mr. A’s first episode of major depression was at age 40, a time of personal stress and bereavement. He and his wife reported that he became anhedonic; slowed mentally; felt sad, hopeless, and fatigued; and experienced a decrease in appetite. He met DSM-IV criteria for major depression, and his score on the Inventory to Diagnose Depression (1) was 38 (a score of 0–10 is normal). A family member had responded to sertraline, so Mr. A was treated similarly, and after 5–6 weeks had a full remission on a dose of 150 mg/day. His scores on repeated administrations of the Inventory to Diagnose Depression ranged from 6 to 11.Mr. A complained about anorgasmia, which began while he was taking 100 mg/day of sertraline, and erectile dysfunction, which began while he was taking 125–150 mg. Although he reported being “annoyed” at this side effect, he felt it was “tolerable.” He then obtained sildenafil from his family doctor.The patient reported that on four occasions, 50 mg of sildenafil allowed him to have his normal erection and ejaculation with no side effects to date. Without the sildenafil, while taking 150 mg/day of sertraline, he experienced a return of his sexual side effects.Sildenafil is now best known as a novel, oral treatment for male erectile dysfunction that acts on a subclass of the phosphodiesterases, specifically, PDE5 (2). Anorgasmia is a common complaint of both men and women treated with selective serotonin reuptake inhibitors (SSRIs), and any new medication that might enhance compliance should be considered. Sildenafil should be tested systematically for treatment of SSRI-induced anorgasmia and erectile dysfunction.References1. Zimmerman M, Coryell W: The Inventory to Diagnose Depression (IDD): a self-report scale to diagnose major depressive disorder. J Consult Clin Psychol 1987; 55:55–59Crossref, Medline, Google Scholar2. Boolell M, Allen MJ, Ballard SA: Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for treatment of penile erectile dysfunction. Int J Impot Res 1996; 8:47–52Medline, Google Scholar FiguresReferencesCited byDetailsCited byOpen-label sildenafil treatment of partial and non-responders to double-blind treatment in men with antidepressant-associated sexual dysfunction27 July 2006 | International Journal of Impotence Research, Vol. 19, No. 2Progress in Neurotherapeutics and Neuropsychopharmacology, Vol. 2, No. 1Reviews in Gynaecological Practice, Vol. 4, No. 2Child and Adolescent Psychopharmacology News, Vol. 9, No. 3JAMA, Vol. 289, No. 1CNS Spectrums, Vol. 8, No. 3Neuropsychopharmacology, Vol. 28, No. 2Urology, Vol. 60, No. 2A new view of women's sexual problems: Why new? Why now?11 January 2010 | The Journal of Sex Research, Vol. 38, No. 2Clinical Therapeutics, Vol. 23, No. 1Journal of Psychiatric Practice, Vol. 7, No. 2Current Psychiatry Reports, Vol. 2, No. 3Physiology & Behavior, Vol. 71, No. 3-4Journal of Sex & Marital Therapy, Vol. 26, No. 4CNS Drugs, Vol. 13, No. 5Journal of Sex & Marital Therapy, Vol. 25, No. 4Journal of Sex & Marital Therapy, Vol. 25, No. 4Reactions Weekly, Vol. &NA;, No. 741Mayo Clinic Proceedings, Vol. 74, No. 7 Volume 156Issue 1 January 1999Pages 156a-157 Metrics History Published online 1 January 1999 Published in print 1 January 1999