Sildenafil for iatrogenic serotonergic antidepressant medication-induced sexual dysfunction in 4 patients

J Clin Psychiatry. 1999 Jan;60(1):33-5. doi: 10.4088/jcp.v60n0107.


Objective: To evaluate the effect of sildenafil on iatrogenic serotonergic antidepressant-induced sexual dysfunction.

Method: Four outpatients (2 men, 2 women) who developed sexual dysfunction (erectile impotence, anorgasmia) during treatment with a serotonin reuptake inhibitor antidepressant for psychiatric disorder were selected. Each subject was initially prescribed sildenafil 50 mg to be taken approximately 1 hour before sexual activity. The dose was increased to 100 mg for a partial or failed response.

Results: Four cases are detailed in case report fashion. All 4 had rapid reversal of their sexual dysfunction, usually with the first dose. Reversal equates to 1 successful use of sildenafil in each of 2 patients and 3 uses in 2 patients.

Conclusion: Sildenafil may be an effective treatment for serotonergic antidepressant-induced sexual dysfunction and deserves further evaluation in randomized placebo-controlled studies.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adult
  • Ambulatory Care
  • Depressive Disorder / drug therapy*
  • Drug Administration Schedule
  • Enzyme Inhibitors / therapeutic use*
  • Female
  • Humans
  • Iatrogenic Disease
  • Male
  • Middle Aged
  • Piperazines / therapeutic use*
  • Purines
  • Serotonin Uptake Inhibitors / adverse effects*
  • Serotonin Uptake Inhibitors / therapeutic use
  • Sexual Dysfunctions, Psychological / chemically induced*
  • Sexual Dysfunctions, Psychological / drug therapy*
  • Sildenafil Citrate
  • Sulfones
  • Treatment Outcome


  • Enzyme Inhibitors
  • Piperazines
  • Purines
  • Serotonin Uptake Inhibitors
  • Sulfones
  • Sildenafil Citrate