Sildenafil Treatment of Paroxetine-Induced Anorgasmia in a Woman

To the Editor: Selective serotonin reuptake inhibiting antidepressants (SSRIs) commonly produce iatrogenic sexual dysfunction (1, 2). Spontaneous remission of SSRI-induced sexual dysfunction is uncommon even after continuing the SSRI for years (2, 3). A variety of augmentation strategies intended to reverse SSRI-induced sexual dysfunction have been proposed (4). Sildenafil, a phosphodiesterase type 5 inhibitor, is indicated in the treatment of male erectile disorder. There are two case reports of men having SSRI-induced sexual dysfunction reversed by sildenafil (unpublished 1998 study by Ashton and Bennett). I report here a case of SSRI-induced anorgasmia in a woman that was reversed by sildenafil.

This letter describes a woman with SSRI-induced anorgasmia without other sexual complaints who had this side effect reversed by taking sildenafil. Since this trial was not controlled, it is possible that the response noted was a placebo effect, although Ms. A had failed prior antidote trials and continued to have a beneficial response. At this point, sildenafil only has Food and Drug Administration approval for use in men with erectile dysfunction. This description of the successful and safe use of sildenafil in a woman may reveal other potential opportunities for using this agent. Further research in this area would be helpful in defining other populations and medical conditions that may be responsive to sildenafil treatment.