Viagra Helps Men on Antidepressants

Sexual problems a key reason they quit the drugs

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By
HealthDay Reporter

FRIDAY, Jan. 3, 2003 (HealthDayNews) -- Viagra can help overcome one of the most common and unpleasant side effects of antidepressant medication: sexual dysfunction.

Not only did Viagra (also known as sildenafil citrate, its generic name) contribute to improvements in sexual function, reports a study appearing in the current issue of the Journal of the American Medical Association, but it also enabled men to keep taking their antidepressants, thus reducing the number of relapses.

The study validates what many physicians already knew, says Dr. Nachum Katlowitz, director of male sexual dysfunction at Maimonides Medical Center in Brooklyn, N.Y. And while there have been other studies, this is the first prospective, well-controlled trial to demonstrate the effectiveness of Viagra for treating this condition.

According to the article, a reported 30 percent to 70 percent of people taking a class of antidepressants called serotonin reuptake inhibitors experience antidepressant-associated sexual dysfunction (AASD). Ninety percent of these people stop taking their medication, which means millions of people may not be getting relief from their depressive symptoms simply because of unpleasant side effects.

Selective and nonselective serotonin reuptake inhibitors are not the only antidepressants that cause sexual dysfunction, but they represent about 90 percent of the market, or 25 million individuals and 95 million prescriptions each year, the article says.

Viagra, which first came on the market in 1998, is used to treat erectile dysfunction. According to Pfizer, which makes the drug and which also funded the current study, nine Viagra tablets are dispensed every second worldwide.

For this study, the authors looked at 90 men who had major depressive disorder in remission as well as AASD. Half of the patients were randomly assigned to receive Viagra and the other half a placebo, both to be taken before sexual activity over the course of six weeks. The mean age of the participants was about 45 years.

Almost 55 percent of the men taking Viagra reported being "much" or "very much" improved on self-administered tests assessing erectile function and improvement in sexual function, including ejaculation, orgasm and satisfaction. Only 4.4 percent of patients taking the placebo reported such an improvement.

A full 85 percent of the original patients completed the study, which in itself is a measure of success: In "real life," less than 30 percent of patients complete the recommended course of antidepressant treatment.

"We kept over 85 percent of the people in the study, and in that period of time we didn't have a single relapse," says Dr. H. George Nurnberg, lead author of the study and a professor of psychiatry at the University of New Mexico School of Medicine. "It's really the compliance piece that's becoming increasingly important and hasn't been recognized. To get better, you have to stay on the drug." Nurnberg is also a paid consultant for Pfizer and other pharmaceutical companies.

"You don't ignore the sex life," Katlowitz adds. "Sex is a strong motivator."

What To Do

For more on depression, visit the National Institute of Mental Health or the National Alliance for the Mentally Ill.

The National Institute of Diabetes and Digestive and Kidney Diseases has more on erectile dysfunction.

SOURCES: H. George Nurnberg, M.D., executive vice chair, department of psychiatry, and professor of psychiatry, University of New Mexico School of Medicine, Albuquerque; Nachum Katlowitz, M.D., director, male sexual dysfunction, Maimonides Medical Center, Brooklyn, N.Y.; Jan. 1, 2003, Journal of the American Medical Association

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