Sildenafil for iatrogenic serotonergic antidepressant medication-induced sexual dysfunction in 4 patients

Objective: To evaluate the effect of sildenafil on iatrogenic serotonergic antidepressant-induced sexual dysfunction. Method: Four outpatients (2 men, 2 women) who developed sexual dysfunction (erectile impotence anorgasmia) during treatment with a serotonin reuptake inhibitor antidepressant for psychiatric disorder were selected. Each subject was initially prescribed sildenafil 50 mg to be taken approximately 1 hour before sexual activity. The dose was increased to 100 mg for a partial or failed response. Results: Four cases are detailed in case report fashion. All 4 had rapid reversal of their sexual dysfunction, usually with the first dose. Reversal equates to 1 successful use of sildenafil in each of 2 patients and 3 uses in 2 patients. Conclusions Sildenafil may be an effective treatment for serotonergic antidepressant-induced sexual dysfunction and deserves further evaluation in randomized placebo-controlled studies.