Unusual case report: Nonpharmacologic effects of sildenafil

Sildenafil (Viagra), by virtue of its conflict-laden symbolic meanings, may be particularly likely to have psychosocial consequences, either therapeutic or disruptive. The author presents two cases of men in their mid-seventies who took sildenafil and who were admitted to a locked geropsychiatry unit because of homicidal ideation toward their wives that occurred while they were not under the direct effect of the drug. In one case, a wife's rejection of her husband's advances seemed to uncover many hidden resentments that they bore toward each other. In the other, sildenafil failed to restore potency to a patient with diabetes, and he developed a jealous delusion that his wife was having an affair.