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WERBUNG
Quelle: Journal
of the American Medical Association
Therapie
der Erektilen Dysfunktion mit Viagra
Eine Vielzahl von Antidepressiva der Gruppe der selektiven und
nicht-selektiven Serotonin-Wiederaufnahme-Hemmer steht im Verdacht
die männliche Sexualfunktion negativ zu beeinflussen. Jetzt konnte
diese im Journal of the American Medical Association ( JAMA)
publizierte Studie zeigen, dass es mit Sildenafil (Viagra ®
) möglich ist, diese Störungen der Sexualfunktion - unter
anderem die Erektile Dysfunktion - erfolgreich zu behandeln.
Dadurch erhöht sich die Wahrscheinlichkeit, dass die unter Depressionen
leidenden Männer bereit sind, eine wirksame Therapie mit einem
Antidepressivum länger durchzuführen.
JAMA.
2003;289:56-64
Treatment of Antidepressant-Associated Sexual Dysfunction With
Sildenafil
A Randomized Controlled Trial
Author Information H. George Nurnberg, MD; Paula L. Hensley, MD;
Alan J. Gelenberg, MD; Maurizio Fava, MD; John Lauriello, MD;
Susan Paine, MPH
Context Sexual dysfunction
is a common adverse effect of antidepressants that frequently
results in treatment noncompliance.
Objective To assess the
efficacy of sildenafil citrate in men with sexual dysfunction
associated with the use of selective and nonselective serotonin
reuptake inhibitor (SRI) antidepressants.
Design, Setting, and Patients
Prospective, parallel-group, randomized, double-blind, placebo-controlled
trial conducted between November 1, 2000, and January 1, 2001,
at 3 US university medical centers among 90 male outpatients (mean
[SD] age, 45 [8] years) with major depression in remission and
sexual dysfunction associated with SRI antidepressant treatment.
Intervention Patients were
randomly assigned to take sildenafil (n = 45) or placebo (n =
45) at a flexible dose starting at 50 mg and adjustable to 100
mg before sexual activity for 6 weeks.
Main Outcome Measures The
primary outcome measure was score on the Clinical Global Impression-Sexual
Function (CGI-SF); secondary measures were scores on the International
Index of Erectile Function, Arizona Sexual Experience Scale, Massachusetts
General Hospital-Sexual Functioning Questionnaire, and Hamilton
Rating Scale for Depression (HAM-D).
Results Among the 90 randomized
patients, 93% (83/89) of patients treated per protocol took at
least 1 dose of study drug and 85% (76/89) completed week 6 end-point
assessments with last observation carried forward analyses. At
a CGI-SF score of 2 or lower, 54.5% (24/44) of sildenafil compared
with 4.4% (2/45) of placebo patients were much or very much improved
(P<.001). Erectile function, arousal, ejaculation, orgasm,
and overall satisfaction domain measures improved significantly
in sildenafil compared with placebo patients. Mean depression
scores remained consistent with remission (HAM-D score 10) in
both groups for the study duration.
Conclusion In our study,
sildenafil effectively improved erectile function and other aspects
of sexual function in men with sexual dysfunction associated with
the use of SRI antidepressants. These improvements may allow patients
to maintain adherence with effective antidepressant treatment.
JAMA. 2003;289:56-64
View Full Text
Author/Article Information
Author Affiliations: Department of Psychiatry, Health Sciences
Center, University of New Mexico School of Medicine, Albuquerque
(Drs Nurnberg, Hensley, and Lauriello, and Ms Paine); Department
of Psychiatry, Arizona Health Sciences Center, Tucson (Dr Gelenberg);
Massachusetts General Hospital, Boston (Dr Fava).
Corresponding Author and Reprints: H. George Nurnberg, MD, Department
of Psychiatry, University of New Mexico School of Medicine, 2400
Tucker NE, Albuquerque, NM 87131-5288 (e-mail: geon@unm.edu).
Financial Disclosures: Dr Nurnberg has received research support
from Bristol-Myers Squibb Co, Eli Lilly & Co, Lilly-Icos,
Pfizer Inc, Wyeth, Novartis, Roche Pharmaceuticals, Pharmacia,
Abbott Laboratories, Johnson & Johnson, and Bayer. He is a
paid consultant for Wyeth, Pfizer Inc, Eli Lilly & Co, GlaxoSmithKline,
and Abbott Laboratories and on the speakers bureau for Pfizer,
Wyeth, Eli Lilly & Co, GlaxoSmithKline, Abbott Laboratories,
and Bayer.
Dr Hensley has received research and grant support from Eli Lilly
& Co, Forest Pharmaceuticals, Novartis, Pfizer Inc, and Roche
Pharmaceuticals. She is a paid consultant for Forest Pharmaceuticals
and Pfizer Inc and is on the speakers bureau for Forest Pharmaceuticals,
Janssen Pharmaceuticals, Eli Lilly & Co, Pfizer Inc, and Wyeth.
Dr Gelenberg has received research support from Bristol-Myers
Squibb Co, Cyberonics, Hoechst Marion Roussel, Eli Lilly &
Co, Pfizer Inc, and Wyeth. He owns stock in Johnson & Johnson
and Pfizer Inc; is a paid consultant for AstraZeneca, Best Practice,
Bristol-Myers Squibb Co, GlaxoSmithKline, Eli Lilly & Co,
Novartis, Vela Pharmaceuticals, and Wyeth; and is on the speakers
bureau for Bristol-Myers Squibb and Wyeth.
Dr Fava has received research support and honoraria from Abbott
Laboratories, Bristol-Myers Squibb Co, Eli Lilly & Co, Forest
Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceuticals, Knoll
Pharmaceuticals, Litchwer Pharma GmbH, Lorex Pharmaceuticals,
Lundbeck, Novartis, Organon Inc, Parke-Davis, Pharmacia, Upjohn
Co, Pharmavite, Pfizer Inc, Roche Pharmaceuticals, Sanofi/Synthelabo
Pharmaceuticals, GlaxoSmithKline, Solvay Pharmaceuticals, Somerset
Pharmaceuticals, and Wyeth.
Author Contributions: Dr Nurnberg, as the principal author of
this study and Ms Paine, as the principal statistician for the
analyses, had full access to all the data in this study and take
full responsibility for the integrity of the data and the accuracy
of the data analyses. All coauthors also had access to the data.
Study concept and design: Nurnberg, Hensley, Gelenberg, Fava,
Lauriello.
Acquisition of data: Nurnberg, Hensley, Gelenberg, Fava, Lauriello.
Analysis and interpretation of data: Nurnberg, Hensley, Gelenberg,
Fava, Paine.
Drafting of the manuscript: Nurnberg, Hensley, Gelenberg, Fava,
Lauriello, Paine.
Critical revision of the manuscript for important intellectual
content: Nurnberg, Hensley, Gelenberg, Fava, Lauriello, Paine.
Statistical expertise: Nurnberg, Paine.
Obtained funding: Nurnberg.
Administrative, technical, or material support: Nurnberg, Hensley,
Gelenberg, Fava.
Study supervision: Nurnberg, Hensley, Gelenberg, Fava, Paine.
Funding/Support: This study was supported by an independent investigator-initiated
grant from Pfizer Inc, New York, NY.
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