A rational combination pharmacotherapy in men with erectile dysfunction who initially failed to oral sildenafil citrate alone: a pilot study.
BACKGROUND
Erectile dysfunction (ED) is a complex condition wherein men with minimal organic ED may develop a variable degree of psychogenic component sufficient to reduce the efficacy of medical management. A combination of trazodone with sildenafil has been used to overcome both organic as well as psychogenic components, thus improving the results of medical management.


OBJECTIVE
To evaluate the efficacy of combination of trazodone with sildenafil citrate in treatment of ED in men with initial failure to sildenafil citrate alone.


METHODS
The symptoms of ED were evaluated using the Erectile Dysfunction Intensity Scale (EDIS) before and after the treatment.


METHODS
Eighteen men with ED who initially failed to respond to sildenafil citrate alone were enrolled in the study between February 2004 and December 2004. All these men were given a priming dose of trazodone for a 2-week period before giving them sildenafil citrate.


RESULTS
Of the 18 men, 12 responded favorably to the above treatment and continued to enjoy good sexual activity while on trazodone and sildenafil. The score on EDIS improved considerably in 12 (66.7%) men, marginally in two (11.1%) men, and did not improve at all in four (22.2%) men.


CONCLUSIONS
Priming the patients with trazodone appears to be a reasonably good alternative in patients who have initial failure to oral sildenafil citrate and have been found to have no organic cause of ED. However, large double-blind studies are required to potentiate this hypothesis.
Taneja
Rajesh
R
Pushpawati Singhania Research Institute--Surgical Division, New Delhi, India. rajeshtanejadr@rediffmail.com
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D003075:Coitus / Q000523:psychology; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage*; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines / Q000008:administration & dosage; D012747:Sexual Partners / Q000523:psychology; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D014196:Trazodone / Q000008:administration & dosage*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D018687:Antidepressive Agents, Second-Generation; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D014196:Trazodone