Wednesday, February 11, 2009

Viagra Improves Sexual Dysfunction In Women On Antidepressants

In women suffering from sexual dysfunction as a result of antidepressant use, this side effect may be relieved by sildanafel, more commonly known as the commercially available Viagra. This was published in an article released on July 22, 2008 in JAMA.

The family of selective seratonin reuptake inhibitors (SSRIs) is a group of antidepressants which prevent the re absorption of the neurotransmitter seratonin into neurons, thus increasing the extracellular concentration of the chemical. They form the most commonly prescribed medications for outpatients between 18 and 65 years, constituting 90% of the 180 million antidepressant prescriptions filled the US.

The authors point out a commonly experienced side effect of SSRI treatment: sexual dysfunction. "Antidepressant treatment associated sexual dysfunction is estimated to occur in 30 percent to 70 percent of men and women treated for major depression with first- or second-generation agents, a principal reason for a 3-fold increased risk of non adherence that approaches 70 percent in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilization by affected patients," they write. Previously, no randomized controlled trials have demonstrated treatment methods that are effective for sexual dysfunction in women due to SSRI use.

To examine this concept, H. George Nurnberg, M.D., of the University of New Mexico School of Medicine, Albuquerque, N.M., and colleagues compared sildenafil to that of a placebo for treatment of SSRI related sexual dysfunction, such as lack of arousal or delayed orgasm. A total 98 women were examined, with an average age of 37 years, all of whom had major depression which was in remission, between September 2003 and January 2007 at seven research centers in the United States. Study subjects were assigned randomly to one of two groups: 49 patients were given sildenafil , and 49 were given a placebo. Both treatments had a flexible dose, beginning at 50 mg and adjustable to 100 mg, between one and two hours before anticipated sexual activity for 8 weeks

In total, 73% of women taking placebo reported no improvement with treatment, in comparison with 25% of women taking sildenafil. When rated by a clinicial for severity improvement, women in the test group showed a greater improvement in sexual function than the women in the placebo group. No patients withdrew from the study due to serious adverse effects, though headache, flushing, and indigestion were frequently reported.

The authors indicate that this is an important finding for women's health in general. They write: "These findings are important not only because women experience major depressive disorder at nearly double the rate of men and because they experience greater resulting sexual dysfunction than men but also because it establishes that selective phosphorescence type 5 inhibitors [such as sildenafil] are effective in both sexes for this purpose. By treating this bothersome treatment-associated adverse effect in patients who have been effectively treated for depression, but need to continue on their medication to avoid relapse or recurrence, patients can remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes."

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