Sildenafil for selective serotonin reuptake inhibitor-induced erectile dysfunction in elderly male depressed patients

Treatment with antidepressants, especially agents with potent serotonergic effects, is frequently associated with sexual side effects. In the present study, we examined the efficacy of sildenafil, a potent phosphodiesterase inhibitor, in the treatment of elderly men (n = 10; 70-81 years) with erectile dysfunction induced by antidepressant treatment for major depressive disorder. Eligible subjects were instructed to add sildenafil (25-50 mg/day) to their current drug treatment. Clinical assessment of erectile function was performed at beginning of treatment with sildenafil and at follow up, 4 weeks later. All patients reported an improvement of their erectile capacity, and in 7 out of 10 subjects, erectile function returned to a normal level. Sildenafil appears to be a safe and well-tolerated agent in elderly subjects. We noted side effects in 2 patients (flashes), but the side-effects were bothersome only to one patient (headache). It appears that sildenafil coadministration improves erectile dysfunction associated with selective serotonin reuptake inhibitor ongoing treatment in elderly patients.