Abstract | OBJECTIVES: METHODS: Twenty four patients with erectile disease were recruited, 12 with Parkinson's disease and 12 with multiple system atrophy, into a randomised, double blind, placebo controlled, crossover study of sildenafil citrate. The starting dose was 50 mg active or placebo medication with the opportunity for dose adjustment depending on efficacy and tolerability. The international index of erectile function questionnaire (IIEF) was used to assess treatment efficacy and a quality of life questionnaire to assess the effect of treatment on sex life and whole life. Criteria for entry included a definite neurological diagnosis and a standing systolic blood pressure of 90-180 mm Hg and diastolic blood pressure of 50-110 mm Hg, on treatment if necessary. Blood pressure was taken at randomisation (visit 2) and crossover (visit 5) lying, sitting, and standing, before and 1 hour after taking the study medication in hospital. RESULTS: Sidenafil citrate was efficacious in men with parkinsonism with a significant improvement, as demonstrated in questionnaire responses, in ability to achieve and maintain an erection and improvement in quality of sex life. In Parkinson's disease there was minimal change in blood pressure between active and placebo medication. In multiple system atrophy, six patients were studied before recruitment was stopped because three men showed a severe drop in blood pressure 1 hour after taking the active medication. Two were already known to have orthostatic hypotension and were receiving treatment with ephedrine and midodrine but the third had asymptomatic hypotension. However, the blood pressures in all three had been within the inclusion criterion for the study protocol. Despite a significant postural fall in blood pressure after sildenafil, all patients with multiple system atrophy reported a good erectile response and were reluctant to discontinue the medication. CONCLUSIONS:
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Authors | I F Hussain, C M Brady, M J Swinn, C J Mathias, C J Fowler |
Journal | Journal of neurology, neurosurgery, and psychiatry
(J Neurol Neurosurg Psychiatry)
Vol. 71
Issue 3
Pg. 371-4
(Sep 2001)
ISSN: 0022-3050 [Print] England |
PMID | 11511713
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Phosphodiesterase Inhibitors
- Piperazines
- Purines
- Sulfones
- Vasoconstrictor Agents
- Midodrine
- Sildenafil Citrate
- Ephedrine
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Topics |
- Aged
- Blood Pressure
(drug effects)
- Cross-Over Studies
- Diastole
- Double-Blind Method
- Ephedrine
(therapeutic use)
- Erectile Dysfunction
(classification, drug therapy, etiology, psychology)
- Humans
- Hypotension, Orthostatic
(chemically induced, diagnosis, drug therapy)
- Male
- Middle Aged
- Midodrine
(therapeutic use)
- Multiple System Atrophy
(complications)
- Parkinson Disease
(complications)
- Phosphodiesterase Inhibitors
(therapeutic use)
- Piperazines
(therapeutic use)
- Purines
- Quality of Life
- Severity of Illness Index
- Sildenafil Citrate
- Sulfones
- Surveys and Questionnaires
- Systole
- Time Factors
- Treatment Outcome
- Vasoconstrictor Agents
(therapeutic use)
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