title: Efficacy of Tadalafil De-Escalation in the Treatment of Psychogenic Erectile Dysfunction.
abstract: OBJECTIVE
  To assess the efficacy of tadalafil de-escalation in the therapeutic effects of psychogenic erectile dysfunction (ED) during the 3 months extension phase.
  
  
  METHODS
  A total of 90 men with mild to severe psychogenic ED were randomly divided into 2 groups: tadalafil 5 mg group and tadalafil de-escalation group. Efficacy assessments included the 5-item version of International Index of Erectile Function (IIEF-5), the Sexual Encounter Profile (SEP) questionnaires, Psychological and Interpersonal Relationship Scales (PAIRS), Erection Hardness Score (EHS).
  
  
  RESULTS
  Compared with the baseline, tadalafil 5 mg and de-escalation groups enhanced all efficacy outcomes. Patients receiving tadalafil 5 mg and de-escalation experienced a significant mean improvement in the psychogenic erectile function domain of the IIEF-5 from the baseline (p < 0.01). The mean change from baseline was significantly higher for the tadalafil de-escalation group than for the tadalafil 5 mg group (p < 0.05). Response to SEP3, PAIRS and EHS was significantly higher in the tadalafil de-escalation group than in the tadalafil 5 mg group (p < 0.05). The severity of ED in the tadalafil de-escalation group had reduced after treatment. It was also significantly better than those in the tadalafil 5 mg group (p < 0.05).
  
  
  CONCLUSIONS
  Tadalafil de-escalation significantly improved the erectile function among psychogenic ED patients. This implies that tadalafil de-escalation treatment for psychogenic ED is worthy of further clinical practice and research.
authors.affiliation: Department of Andrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Li
authors.forename: Haiyan
authors.initials: H
authors.lastname: Lan
authors.forename: Jihong
authors.initials: J
authors.lastname: Liang
authors.forename: Chengmei
authors.initials: C
authors.lastname: Zhang
authors.forename: Cunchao
authors.initials: C
authors.lastname: Huang
mesh_terms: D000328:Adult; D002243:Carbolines / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010410:Penile Erection / Q000187:drug effects*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D000068581:Tadalafil / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D064804:Urological Agents / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002243:Carbolines; D064804:Urological Agents; D000068581:Tadalafil