The phosphodiasterase 5-inhibitors (PDE-5i) for erectile dysfunction (ED)

A therapeutic challenge for psychiatrists

Chong Siew Koon, Hatta Sidi, Jaya Kumar, Ong Wan Xi, Srijit Das, Muhammad Hizri Hatta, Cesar Alfonso

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually initiates orgasm – a biopsychophysiological state of euphoria – leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in this context and constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial’s guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits/ flexibilities and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male’s self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one’s sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED.

Original languageEnglish
Pages (from-to)1366-1377
Number of pages12
JournalCurrent Drug Targets
Volume19
Issue number12
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint

Erectile Dysfunction
Psychiatry
Guanosine Monophosphate
Coitus
Oxytocin
Muscle
Nitric Oxide
Availability
Premature Ejaculation
Orgasm
Foster Home Care
Therapeutics
Treatment Failure
Self Concept
Smooth Muscle
Life Style
Vardenafil Dihydrochloride
Sildenafil Citrate
Tadalafil

Keywords

  • Body-mass index
  • Erectile dysfunction
  • Hypertension
  • PDE-5 inhibitor
  • Psychiatric management of ED
  • Sexual fantasy

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology
  • Drug Discovery
  • Clinical Biochemistry

Cite this

The phosphodiasterase 5-inhibitors (PDE-5i) for erectile dysfunction (ED) : A therapeutic challenge for psychiatrists. / Koon, Chong Siew; Sidi, Hatta; Kumar, Jaya; Xi, Ong Wan; Das, Srijit; Hatta, Muhammad Hizri; Alfonso, Cesar.

In: Current Drug Targets, Vol. 19, No. 12, 01.01.2018, p. 1366-1377.

Research output: Contribution to journalReview article

Koon, Chong Siew ; Sidi, Hatta ; Kumar, Jaya ; Xi, Ong Wan ; Das, Srijit ; Hatta, Muhammad Hizri ; Alfonso, Cesar. / The phosphodiasterase 5-inhibitors (PDE-5i) for erectile dysfunction (ED) : A therapeutic challenge for psychiatrists. In: Current Drug Targets. 2018 ; Vol. 19, No. 12. pp. 1366-1377.
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