0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters to the Editor   |    
Sildenafil Citrate for SSRI-Induced Sexual Side Effects
JAMES L. SCHALLER, M.D., M.A.R.; DAVID BEHAR, M.D.
Am J Psychiatry 1999;156:156a-157.

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 (R15601CHDDJICB) 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 (R15601CHDBBICF). 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.

Zimmerman M, Coryell W: The Inventory to Diagnose Depression (IDD): a self-report scale to diagnose major depressive disorder. J Consult Clin Psychol  1987; 55:55–59
[PubMed]
[CrossRef]
 
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; 8:47–52
[PubMed]
 
+

References

Zimmerman M, Coryell W: The Inventory to Diagnose Depression (IDD): a self-report scale to diagnose major depressive disorder. J Consult Clin Psychol  1987; 55:55–59
[PubMed]
[CrossRef]
 
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; 8:47–52
[PubMed]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 20.  >
APA Practice Guidelines > Chapter 7.  >
APA Practice Guidelines > Chapter 7.  >
APA Practice Guidelines > Chapter 7.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 3.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles