It's possibly the most highly advertised and discussed medication in the history of the pharmaceutical industry. It's that "little blue pill," Viagra.
A July JAMA article reports on a study testing Viagra (sidenafil) to offset the sexual dysfunction side effects of selective serotonin reuptake inhibitor and nonselective serotonin reuptake inhibitor antidepressants (SRIs). Other studies have suggested that Viagra may be effective for this purpose, but this study is one of the first to show that it is effective.
For women taking selective SRIs , sexual dysfunction is, unfortunately, a frequent side effect. This sexual dysfunction in women can manifest as decreased sexual interest, vaginal lubrication, and genital sensitivity; delayed or absent orgasm; and overall decreased satisfaction or loss of pleasure in sexual relations.
According to the JAMA article, sexual dysfuncion as a side effect of antidepressants is estimated to occur in 30% to 70% of women and men. This, of course, has a negative impact on quality of life and relationships. In addition, it increases the likelihood of patients not taking the medications, which can result in relapse, worsening depression, recurrence, and disability.
Study results: Of the women who received Viagra in the study, 72% reported sexual improvement, while only 27% of women who received the placebo reported improvement.
In reporting the study, Nurnberg et al wrote,
"By treating this bothersome treatment-associated adverse effect ... patients can remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes... These findings are important not only because women experience major depressive disorder at nearly double the rate of men and because they experience greater resulting sexual dysfunction than men, but also because it establishes that (drugs such as sildenafil) are effective in both sexes for this purpose."
Summary and comments:
Depression itself can produce sexual dysfunction. When the medications used to treat depression add to that dysfunction, it can have quite serious implications all the way around -- in the person's self esteem, quality of life, and relationships. To avoid this, many patients stop taking the medications.
This study gives a bit of hope to women suffering through sexual dysfunction as a side effect of SRIs. Still, it's a band-aid. More research needs to be done to develop medications that do not have this adverse effect.
Taking a second medication to counteract side effects of the first medication is not the best answer. Viagra can have side effects of its own and should not be taken by people with cardiovasular disease and some other illnesses. It is also expensive.
These coments should not be interpreted to take away from the significance of the study discussed. Still, now that we have a potential band-aid, I'm hoping for antidepressants with fewer potential side effects.