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| |  Sildenafil Improves Antidepressant-Related Sexual Dysfunction in Women CHICAGO -- July 22, 2008 -- Women with sexual dysfunction caused by the use of antidepressants experienced a reduction in adverse sexual effects with the use of sildenafil, according to a study in the July 23 issue of JAMA. "Antidepressant treatment-associated sexual dysfunction is estimated to occur in 30% to 70% 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% in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilisation by affected patients," the authors wrote. It is believed that no randomised, controlled trial has demonstrated an effective treatment for women experiencing sexual dysfunction associated with serotonin reuptake inhibitors (SRIs). H. George Nurnberg, MD, University of New Mexico School of Medicine, Albuquerque, New Mexico, and colleagues compared the efficacy of sildenafil against placebo for treatment of sexual dysfunction associated with SRI treatment with major depression in remission. The randomised, controlled trial included 98 women (mean age 37 years) and was conducted between September 2003 and January 2007. 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 1 to 2 hours before anticipated sexual activity, for 8 weeks. The researchers found that 73% of women taking placebo compared with 28% 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 are effective in both sexes for this purpose," the authors wrote. By receiving therapy for this bothersome treatment-associated adverse effect, patients who have been effectively treated for depression but need to continue on their medication to avoid relapse or recurrence can "remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes." SOURCE: JAMA
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