Viagra Not Just for Old Men: Study Finds It Helps
Some Women with Sexual Dysfunction
Sildenafil improves antidepressant-related sexual
problems in women
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July 23, 2008 Viagra not just helpful to older
men, says a new study that finds women 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 treatmentassociated 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. The average age of the women
was 37 and all had suffered with major depression that was 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 (49) or
placebo (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.
Watch Video
Antidepressants, known as SRIs or serotonin
reuptake inhibitors, are the most frequently prescribed medications in
the U.S. for adults with depression. For many women, who have almost
twice the rate of depression compared to men, they can be very
effective. But they are also associated with sexual side effects. Now a
new study finds that sildenafil, also known as Viagra, a medication
marketed to treat erectile dysfunction in men, may also help treat these
sexual side effects in women. Jennifer Mitchell explains in this weeks
JAMA Report.
Click here to video .
