Sildenafil

current as of August 9, 2009.
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http://jama.ama-assn.org/cgi/content/full/300/4/395
JAMA. 2008;300(4):395-404 (doi:10.1001/jama.300.4.395)
H. George Nurnberg; Paula L. Hensley; Julia R. Heiman; et al.
Randomized Controlled Trial
Antidepressant-Associated Sexual Dysfunction: A
Sildenafil Treatment of Women With
Supplementary materialhttp://jama.ama-assn.org/cgi/content/full/300/4/395/DC1
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Function; Randomized Controlled Trial; Drug Therapy; Adverse Effects
Psychiatry; Depression; Psychopharmacology;Women's Health; Women's Sexual
Related Letters
Liu Hong et al. JAMA. 2008;300(20):2365.
Lisa Harinstein. JAMA. 2008;300(20):2365.
Sildenafil as Treatment for Antidepressant-Induced Sexual Dysfunction
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ORIGINAL CONTRIBUTION
Sildenafil Treatment of Women With
Antidepressant-Associated Sexual Dysfunction
A Randomized Controlled Trial
H. George Nurnberg, MD
Paula L. Hensley, MD
Julia R. Heiman, PhD
Harry A. Croft, MD
Charles Debattista, MD
Susan Paine, MPH TREATMENT-EMERGENT SEXUAL
dysfunction is a frequent adverseeffect occurring with medication
use and is a major influence
for premature discontinuation of
antidepressant treatment, which leads to
treatment failure and costly disease management
outcomes. Sexual dysfunction
is recognized as being associated with selective
and nonselective serotonin reuptake
inhibitor (SRI) antidepressants,
which are the most frequently prescribed
medications foroutpatients aged
18 to 65 years and represent 90% of the
180 million antidepressant prescriptions
filled in the United States.1
Antidepressant treatment–associated
sexual dysfunction is estimated to
occur in 30% to 70% of men and
women treated for major depression
with first- or second-generation agents,2
a principal reason for a 3-fold increased
risk of nonadherence that approaches
70% inthe first months of
treatment and leads to increased relapse,
recurrence, disability, and resource
utilization by affected patients.
3 However, the literature in this
field is less developed for women with
more highly variable prevalence rates
and less conclusive data compared with
Author Affiliations: Department of Psychiatry, Health
Sciences Center, University of New Mexico School ofMedicine, Albuquerque (Drs Nurnberg and Hensley,
and Ms Paine); The Croft Group, San Antonio, Texas
(Dr Croft); the Kinsey Institute for Research in Sex, Gender,
and Reproduction, Indiana University, Bloomington
(Dr Heiman); and Stanford University School
of Medicine, Palo Alto, California (Dr DeBattista).
Corresponding Author: H. George Nurnberg, MD, Departmentof
Psychiatry, UniversityofNewMexicoSchool
of Medicine, 2400 Tucker NE,MC09 5030, Albuquerque,
NM 87131-0001 (gnurnberg@salud.unm.edu).
Context Antidepressant-associated sexual dysfunction is a common adverse effect
that frequently results in premature medication treatment discontinuation and for which
no treatment has demonstrated efficacy in women.
Objective To evaluate the efficacy of sildenafil for sexual dysfunctionassociated with
selective and nonselective serotonin reuptake inhibitors (SRIs) in women.
Design, Setting, and Participants An 8-week prospective, parallel-group, randomized,
double-blind, placebo-controlled clinical trial conducted between September
1, 2003, and January 1, 2007, at 7 US research centers that included 98 previously sexually
functioning, premenopausal women (mean [SD] age...