Zusammenfassung
Die erektile Dysfunktion (ED) ist eine weitverbreitete und schambehaftete Störung.
Sie kann als Symptom einer Depression oder als unerwünschte Wirkung antidepressiver
Medikation auftreten. ED führt häufig zum Therapieabbruch insbesondere in der Rezidivprophylaxe.
Mit den Phosphodiesterasehemmern wie Sildenafil, Tadalafil und Vardenafil können erektile
Dysfunktionen multipler Genese erfolgreich behandelt werden. Durch den komplementären
Einsatz in der Psychiatrie kann eine Verbesserung bei der Behandlung bestimmter Depressionsformen
erzielt werden. Außerdem kann sich dadurch die Compliance medikamentöser antidepressiver
Therapien erhöhen.
Abstract
Erectile dysfunction (ED) is a common problem in the general population, but also
a symptom of both treated and untreated depression. As a side effect of antidepressant
medication, erectile dysfunction appears to be one of the principal reasons for discontinuing
antidepressant treatment. Avoiding or switching antidepressants is problematic, as
this may lead to an increase in depressive symptoms. Our review shows that oral phosphodiesterase
inhibitors are an option in treating both ED resulting from depression and from antidepressant
medication.
Literatur
1
Bauer M, Whybrow P C, Angst J. et al .
World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological
Treatment of Unipolar Depressive Disorders, Part 1: Acute and continuation treatment
of major depressive disorder.
World J Biol Psychiatry.
2002;
3
5-43
2
Nurnberg H G, Hensley P L.
Sildenafil citrate for the management of antidepressant-associated erectile dysfunction.
J Clin Psychiatry.
2003;
64 (Suppl 10)
20-25
3
NIH Consensus Conference .
Impotence. NIH Consensus Development Panel on Impotence.
JAMA.
1993;
270
83-90
4
Derouet H, Osterhage J, Sittinger H.
Erektile Funktionsstörungen - Epidemiologie, Physiologie, Ätiologie, Diagnostik und
Therapie.
Nervenarzt.
2004;
75
595-605
5
Fazio L, Brock G.
Erectile dysfunction: management update.
CMAJ.
2004;
170
1429-1437
6
Mann K, Pankok J, Connemann B. et al .
Sleep investigations in erectile dysfunction.
J Psychiatr Res.
2005;
39
93-99
7
Seidman S N.
Exploring the relationship between depression and erectile dysfunction in aging men.
J Clin Psychiatry.
2002;
63 (Suppl 5)
5-12
8
Araujo A B, Durante R, Feldman H A. et al .
The relationship between depressive symptoms and male erectile dysfunction: cross-sectional
results from the Massachusetts Male Aging Study.
Psychosom Med.
1998;
60
458-465
9
Araujo A B, Johannes C B, Feldman H A. et al .
Relation between psychosocial risk factors and incident erectile dysfunction: prospective
results from the Massachusetts Male Aging Study.
Am J Epidemiol.
2000;
152
533-541
10
Rosen R C, Marin H.
Prevalence of antidepressant-associated erectile dysfunction.
J Clin Psychiatry.
2003;
64 (Suppl 10)
5-10
11
Braun M, Wassmer G, Klotz T. et al .
Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’.
Int J Impot Res.
2000;
12
305-311
12
Schäfer G A, Englert H S, Ahlers C J. et al .
Erektionsstörung und Lebensqualität - Erste Ergebnisse der Berliner Männer-Studie.
Sexuologie.
2003;
10
50-60
13
Nicolosi A, Moreira Jr E D, Shirai M. et al .
Epidemiology of erectile dysfunction in four countries: cross-national study of the
prevalence and correlates of erectile dysfunction.
Urology.
2003;
61
201-206
14
Shabsigh R, Klein L T, Seidman S. et al .
Increased incidence of depressive symptoms in men with erectile dysfunction.
Urology.
1998;
52
848-852
15
Steiger A, Holsboer F, Benkert O.
Studies of nocturnal penile tumescence and sleep electroencephalogram in patients
with major depression and in normal controls.
Acta Psychiatr Scand.
1993;
87
358-363
16
Nicolosi A, Moreira Jr E D, Villa M. et al .
A population study of the association between sexual function, sexual satisfaction
and depressive symptoms in men.
J Affect Disord.
2004;
82
235-243
17
Kantor J, Bilker W B, Glasser D B. et al .
Prevalence of erectile dysfunction and active depression: an analytic cross-sectional
study of general medical patients.
Am J Epidemiol.
2002;
156
1035-1042
18
Souverein P C, Egberts A C, Sturkenboom M C. et al .
The Dutch cohort of sildenafil users: baseline characteristics.
BJU Int.
2001;
87
648-653
19
Rosen R C, Lane R M, Menza M.
Effects of SSRIs on sexual function: a critical review.
J Clin Psychopharmacol.
1999;
19
67-85
20
Ekselius L, Knorring L von.
Effect on sexual function of long-term treatment with selective serotonin reuptake
inhibitors in depressed patients treated in primary care.
J Clin Psychopharmacol.
2001;
21
154-160
21
Kennedy S H, Eisfeld B S, Dickens S E. et al .
Antidepressant-Induced Sexual Dysfunction During Treatment With Moclobemide, Paroxetine,
Sertraline, and Venlafaxine.
J Clin Psychiatry.
2000;
61
276-281
22
Montejo-Gonzalez A L, Llorca G, Izquierdo J A. et al .
SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine
in a prospective, multicenter, and descriptive clinical study of 344 patients.
J Sex Marital Ther.
1997;
23
176-194
23
Philipp M, Tiller J W, Baier D. et al .
Comparison of moclobemide with selective serotonin reuptake inhibitors (SSRIs) on
sexual function in depressed adults. The Australian and German Study Groups.
Eur Neuropsychopharmacol.
2000;
10
305-314
24
Fink H A, MacDonald R, Rutks I R. et al .
Trazodone for erectile dysfunction: a systematic review and meta-analysis.
BJU Int.
2003;
92
441-446
25
Nurnberg H G, Seidman S N, Gelenberg A J. et al .
Depression, antidepressant therapies, and erectile dysfunction: clinical trials of
sildenafil citrate (Viagra) in treated and untreated patients with depression.
Urology.
2002;
60
58-66
26
Goldstein I, Lue T F, Padma-Nathan H. et al .
Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group.
N Engl J Med.
1998;
338
1397-1404
27
Seidman S N, Roose S P, Menza M A. et al .
Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled
trial with sildenafil citrate.
Am J Psychiatry.
2001;
158
1623-1630
28
Muller M J, Benkert O.
Lower self-reported depression in patients with erectile dysfunction after treatment
with sildenafil.
J Affect Disord.
2001;
66
255-261
29
Tignol J, Furlan P M, Gomez-Beneyto M. et al .
Efficacy of sildenafil citrate (Viagra) for the treatment of erectile dysfunction
in men in remission from depression.
Int Clin Psychopharmacol.
2004;
19
191-199
30
Milman H A, Arnold S B.
Neurologic, psychological, and aggressive disturbances with sildenafil.
Ann Pharmacother.
2002;
36
1129-1134
31
Schultheiss D, Muller S V, Nager W. et al .
Central effects of sildenafil (Viagra) on auditory selective attention and verbal
recognition memory in humans: a study with event-related brain potentials.
World J Urol.
2001;
19
46-50
32
Grass H, Klotz T, Fathian-Sabet B. et al .
Sildenafil (Viagra): is there an influence on psychological performance?.
Int Urol Nephrol.
2001;
32
409-412
33
Arnavaz A, Aurich A, Weissenborn K. et al .
Effect of sildenafil (Viagra) on cerebral blood flow velocity: a pilot study.
Psychiatry Res.
2003;
122
207-209
34
Kruuse C, Thomsen L L, Jacobsen T B. et al .
The phosphodiesterase 5 inhibitor sildenafil has no effect on cerebral blood flow
or blood velocity, but nevertheless induces headache in healthy subjects.
J Cereb Blood Flow Metab.
2002;
22
1124-1131
35
Morales A, Gingell C, Collins M. et al .
Clinical safety of oral sildenafil citrate (VIAGRA) in the treatment of erectile dysfunction.
Int J Impot Res.
1998;
10
69-73
36
Labbate L A, Croft H A, Oleshansky M A.
Antidepressant-related erectile dysfunction: management via avoidance, switching antidepressants,
antidotes, and adaptation.
J Clin Psychiatry.
2003;
64 (Suppl 10)
11-19
37
Montejo A L, Llorca G, Izquierdo J A. et al .
Incidence of sexual dysfunction associated with antidepressant agents: a prospective
multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related
Sexual Dysfunction.
J Clin Psychiatry.
2001;
62 (Suppl 3)
10-21
38
Fava M, Rankin M.
Sexual functioning and SSRIs.
J Clin Psychiatry.
2002;
63 (Suppl 5)
13-16
39
Kang B J, Lee S J, Kim M D. et al .
A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced
sexual dysfunction.
Hum Psychopharmacol.
2002;
17
279-284
40
Nelson E B, Shah V N, Welge J A. et al .
A placebo-controlled, crossover trial of granisetron in SRI-induced sexual dysfunction.
J Clin Psychiatry.
2001;
62
469-473
41
Masand P S, Ashton A K, Gupta S. et al .
Sustained-release bupropion for selective serotonin reuptake inhibitor-induced sexual
dysfunction: a randomized, double-blind, placebo-controlled, parallel-group study.
Am J Psychiatry.
2001;
158
805-807
42
Nurnberg H G, Gelenberg A, Hargreave T B. et al .
Efficacy of sildenafil citrate for the treatment of erectile dysfunction in men taking
serotonin reuptake inhibitors.
Am J Psychiatry.
2001;
158
1926-1928
43
Nurnberg H G, Hensley P L, Gelenberg A J. et al .
Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized
controlled trial.
JAMA.
2003;
289
56-64
44
Nurnberg H G, Duttagupta S.
Economic analysis of sildenafil citrate (Viagra) add-on to treat erectile dysfunction
associated with selective serotonin reuptake inhibitor use.
Am J Ther.
2004;
11
9-12
Dr. med. Sebastian Walther
Universitäre Psychiatrische Dienste Bern · Direktion Sozial- und Gemeindepsychiatrie
Bolligenstrasse 111
3000 Bern 60
Schweiz
Email: Sebastian.Walther@gef.be.ch