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Erectile dysfunction in patients taking psychotropic drugs and treated with phosphodiesterase-5 inhibitors

Rossella Mazzilli, Gloria Angeletti, Soraya Olana, Michele Delfino, Virginia Zamponi, Chiara Rapinesi, Antonio Del Casale, Georgios D. Kotzalidis, Jlenia Elia, Gemma Callovini, Paolo Girardi, Fernando Mazzilli
  • Rossella Mazzilli
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy | rossella.mazzilli@uniroma1.it
  • Gloria Angeletti
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Soraya Olana
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Michele Delfino
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Virginia Zamponi
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Chiara Rapinesi
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Antonio Del Casale
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome,
  • Georgios D. Kotzalidis
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Jlenia Elia
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Gemma Callovini
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Paolo Girardi
    NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy
  • Fernando Mazzilli
    Andrology Unit, Sant’Andrea Hospital, Sapienza University of Rome, School of Medicine and Psychology, Rome, Italy

Abstract

Objectives: The aim of this study was to assess the prevalence of patients with Erectile Dysfunction (ED) receiving psychotropic drugs, the impact of these drugs on hormonal profile, and the efficacy of PDE5-i in these patients.
Materials and methods: We recruited 1872 patients referring for ED to our Andrology Unit. Assessment included serum testosterone, gonadotropins, TSH, prolactin, and PSA, and the IIEF-5 questionnaire for ED diagnosis. Inclusion criteria were age 21-75 years and IIEF-5 total score ≤ 21; exclusion criteria included hypogonadism, diabetes mellitus, previous prostatectomy, other medication intake, and ED diagnosis prior to psychotropic drug treatment. Efficacy was rated with the IIEF-5 (remission: total score ≥ 22).
Results: The prevalence of ED patients treated with psychotropic drugs since ≥ 3 months was 9.5% (178/1872), subdivided according to the drugs used into: Group A, 16 patients treated with atypical antipsychotics (9.0%); Group B, 55 patients with benzodiazepines (30.9%); Group C, 33 patients with antidepressant drugs (18.5%); and Group D, 74 patients with multiple psychotropic drugs (41.6%). Patients in Group A were significantly younger than other groups (p < 0.05). The hormonal profile presented only higher prolactin level in patients treated with antipsychotics, alone or in combination (p < 0.05). Overall, 146 patients received PDE5-i. Remission rate, after three months of treatment, was significantly higher in Group B compared to C and D groups (p < 0.05).
Conclusions: A substantial portion of patients receiving psychotropic drugs show ED. Sexual performance in these patients benefits from PDE5-i. Age, effects of psychiatric disorders, psychotropic drugs, and PDE5-i treatment modality accounted for variability of response in this sample.

Keywords

Erectile dysfunction; Psychotropic drugs; Phosphodiesterase 5-inhibitors; Antipsychotic drugs; Antidepressant drugs; Benzodiazepines

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Submitted: 2017-12-29 15:34:23
Published: 2018-03-31 00:00:00
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Copyright (c) 2018 Rossella Mazzilli, Gloria Angeletti, Soraya Olana, Michele Delfino, Virginia Zamponi, Chiara Rapinesi, Antonio Del Casale, Giorgio Kotzalidis, Jlenia Elia, Gemma Callovini, Paolo Girardi, Fernando Mazzilli

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