title: Change in symptoms of erectile dysfunction in depressed men initiating buprenorphine therapy.
abstract: OBJECTIVE
  The aim of this study is to describe the change in erectile dysfunction (ED) symptoms in the first 12 weeks of outpatient buprenorphine therapy.
  
  
  BACKGROUND
  Erectile dysfunction is highly prevalent in men who use illicit opioids when compared with the general population. To date, no study has examined ED symptoms over time in men initiating buprenorphine therapy for opioid dependence.
  
  
  METHODS
  A randomized, double blind, placebo-controlled trial was conducted to determine whether escitalopram treatment of depressive symptoms begun 1 week prior to buprenorphine induction would improve treatment retention. Male patients completed the International Index of Erectile Function scale at baseline prior to induction and monthly thereafter. A score of 25 or less on the erectile function domain (range 1-30) is considered indicative of erectile dysfunction.
  
  
  RESULTS
  A total of 111 male subjects enrolled: mean age 38.5 (±9.7) years, 80.1% non-Hispanic Caucasian; 67.3% reported heroin as their opioid of choice. Mean IIEF at baseline was 20.4 (±10.5). At baseline, 44.1% of the entire cohort had erectile dysfunction; among those who identified as sexually active at baseline, 26.1% had ED. Baseline erectile function was inversely and significantly correlated with age (r=-.27, p=.006), but was not associated significantly with race, heroin use, years of opioid use, smoking, or hazardous use of alcohol. Compared to baseline, mean erectile function was significantly improved (p=.001) at 3 months, and sexual desire (p=.002) improved significantly at both 2- and 3-month assessments.
  
  
  CONCLUSIONS
  Erectile dysfunction is highly prevalent in depressed males using illicit opioids. Men who remain in buprenorphine treatment for 3 months show improvement in erectile function and sexual desire.
authors.affiliation: Brown University, Center for Alcohol and Addiction Studies, Providence RI, 02903, USA. Electronic address: Patricia_Cioe@brown.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cioe
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Anderson
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stein
mesh_terms: D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D002047:Buprenorphine / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy; D004311:Double-Blind Method; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D015995:Prevalence; D013997:Time Factors
chemical_list: D015283:Citalopram; D002047:Buprenorphine
keywords: Buprenorphine; Erectile dysfunction; Opioid dependence
references.citation: J Sex Med. 2012 Oct;9(10):2698-707
references.pmid: 22897716
references.citation: Ann Pharmacother. 2002 Oct;36(10):1577-89
references.pmid: 12243609
references.citation: J Addict Dis. 2005;24(2):91-106
references.pmid: 15784526
references.citation: Drug Alcohol Depend. 2008 Apr 1;94(1-3):12-8
references.pmid: 18083312
references.citation: Int J Impot Res. 2011 Sep-Oct;23(5):227-34
references.pmid: 21716296
references.citation: Endocr Rev. 2010 Feb;31(1):98-132
references.pmid: 19903933
references.citation: Am J Psychiatry. 1980 Aug;137(8):909-15
references.pmid: 6774622
references.citation: J Clin Psychopharmacol. 2009 Jun;29(3):259-66
references.pmid: 19440080
references.citation: J Addict Dis. 2010 Oct;29(4):455-60
references.pmid: 20924881
references.citation: Arch Gen Psychiatry. 1961 Jun;4:561-71
references.pmid: 13688369
references.citation: Int J Impot Res. 2002 Aug;14(4):226-44
references.pmid: 12152111
references.citation: J Clin Endocrinol Metab. 2005 Jan;90(1):203-6
references.pmid: 15483091
references.citation: Drugs Today (Barc). 2008 Feb;44(2):147-68
references.pmid: 18389091
references.citation: J Sex Med. 2008 Mar;5(3):684-92
references.pmid: 18093096
references.citation: J Subst Abuse Treat. 2010 Sep;39(2):157-66
references.pmid: 20598836
references.citation: J Sex Med. 2009 Apr;6(4):1072-1080
references.pmid: 18093094
references.citation: Neuroscience. 2006 Jul 7;140(3):929-37
references.pmid: 16580783
references.citation: Eur Urol. 2011 Nov;60(5):1010-6
references.pmid: 21855209
references.citation: J Addict Med. 2012 Sep;6(3):212-8
references.pmid: 22614937
references.citation: Urology. 1997 Jun;49(6):822-30
references.pmid: 9187685
references.citation: J Sex Med. 2009 Jun;6(6):1506-1533
references.pmid: 19453889
references.citation: Am J Drug Alcohol Abuse. 1977;4(1):13-20
references.pmid: 565588
references.citation: Am J Med. 2007 Feb;120(2):151-7
references.pmid: 17275456
references.citation: J Clin Psychopharmacol. 2009 Apr;29(2):157-64
references.pmid: 19512977