The interrelation between male sexual
dysfunction and
depression With the advent of effective medication for the treatment
of both depression and erectile
dysfunction there has emerged a complicated interrelation between the cause and effect of one condition and the other. It is well known that erective dysfunction,
is a common accompanying symptom of mild or major depression disorders, the worse the depression the more common the occurrence of ED . To add salt to an open wound the use of common antidepressants of the selective serotonin reuptake inhibitor , types, such as “Paxil and Prozac”, further increased the probability of ED complicating the clinical picture of the depressed patient. It was convincingly demonstrated by a double blind randomized controlled study published in The Journal of the American Medical Association, January 1 2002 issue that Sildenafil, (Viagra), a phosphodiesterase-5 inhibitor was an effective antidote for ED caused or exacerbated by SSRI therapy, as measured by improved erectile function, arousal, ejaculation, orgasm, and overall satisfaction. In conclusion the article stressed the importance of managing the common medication induced side effect of ED, with antidote medications of the PDE-5 variety to improve depression treatment outcomes with SSRI’s. In a more recent study the relation between depression and erectile dysfunction was further explored. In the January issue of the American Journal of Psychiatry an article was published that noted improvement of both mild depression and erectile dysfunction with the sole use of daily Vardenafil, also a phosphodiesterase-5 inhibitor, like Viagra. In a parallel-group, double-blind study, 280 men with erectile dysfunction and untreated mild major depression were administered either Vardenafil or placebo. Useing the International Index of Erectile Function and the 17-item Hamilton Depression Rating Scale (HAM-D) scores as markers, the groups were reevaluated every 4 weeks. There was excellent improvement in all medication treated patient for both ED and depression when compared to the placebo group. It is hypothesized that there is no direct medication effect from the PDE-5 on the brain in regards to improved depression symptoms, but rather the improvement is due to an indirect effect from improved sexual performance resulting in superior self esteem, and quality of life related to better sexual relations and interpersonal dynamics brought about by the effects of the PDE-5. In that ED and depression are common afflicts of our society. These two studies highlight the need for a deeper understanding of the cause and effects of ED, depression and medication treatment options. Further research utilizing a broader spectrum of clinical presentations and longer treatment periods will undoubtedly pave the way to a better understanding of the cause of these ailments and open the way for improved treatment options. Dr. Luis J. Perez