Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial.
My antidepressant is working for my mood but has wrecked my erections — is adding sildenafil something you'd consider before we change the antidepressant?
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: The funding statement reads: "This study was supported by an independent investigator-initiated grant from Pfizer Inc, New York, NY." Pfizer makes sildenafil. Several authors also disclose research support, consulting fees, or speakers-bureau payments from Pfizer. The trial predates routine registration, so there is no pre-registered protocol to check the reported outcomes against.
In 90 men whose depression was in remission on a serotonin reuptake inhibitor but who had drug-associated sexual dysfunction, 6 weeks of flexible-dose sildenafil produced much or very much improvement in 54.5% (24/44) versus 4.4% (2/45) on placebo. Erectile function, arousal, ejaculation, orgasm, and satisfaction all improved, and depression scores stayed in remission in both arms. It is a 6-week trial in 90 men, so it says nothing about long-term use.
Worth asking
My antidepressant is working for my mood but has wrecked my erections — is adding sildenafil something you'd consider before we change the antidepressant?
What to watch for
Evidence quality tells you whether to trust the finding — not whether the treatment is safe. These are the risks this research reports.
- Persistent sexual dysfunction (PSSD)
- Sexual side effects
Source
Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. — Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S. (2003)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1001/jama.289.1.56
DOI: 10.1001/jama.289.1.56
How this was scored
- Study design
- Randomised controlled trial
- Funding
- Industry funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 90
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- No
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "early signal". Suggestive but preliminary. Not settled. It scores 51 out of 100 on our published rubric. One caveat travels with that badge: The funding statement reads: "This study was supported by an independent investigator-initiated grant from Pfizer Inc, New York, NY." Pfizer makes sildenafil. Several authors also disclose research support, consulting fees, or speakers-bureau payments from Pfizer. The trial predates routine registration, so there is no pre-registered protocol to check the reported outcomes against. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. — Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S. (2003). Published in: Top-tier peer-reviewed journal. DOI: 10.1001/jama.289.1.56. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Randomised controlled trial. Funding: Industry funded. The researchers were not independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.