The latest study was confined to women with arousal problems. They all had been diagnosed with major depression and were taking a specific class of antidepressants called selective serotonin re-uptake inhibitors, or SSRIs. Their depression was in remission when the study began.
The women, all of whom were premenopausal, were divided into two groups. One group was assigned to take Viagra one to two hours before sexual activity for eight weeks. The other women received the same instructions but were given a placebo.
At the end of the study, 72% of women taking Viagra, and 27% of those taking the placebo, reported improvement. The side effects were those typically associated with Viagra, including headaches and flushing. The women who responded best tended to have higher levels of testosterone, a phenomenon also observed in men taking Viagra.
Goldstein, who consults for Pfizer and other drug companies, said testosterone levels may be the key. A recent study in Italy found that Viagra helped female diabetics with normal testosterone levels.
"What is so cool about this paper is that women with sexual problems have another drug they can use," Goldstein said. "As long as their testosterone values are OK, we can help them."
Julia R. Heiman, director of the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University and a study author, said the findings were important because the sexual side effects of antidepressants can be so debilitating that women discontinue the medication, putting themselves at risk for greater depression.
"This will change practice," said Dr. Andrew Leuchter, a professor of psychiatry at UCLA who was not involved in the study.
Dr. Glenn D. Braunstein, an endocrinologist and chairman of the department of medicine at Cedars-Sinai Medical Center, said Viagra might not work as well in the real world as it did in the study. Patients who experienced headaches or flushing might have figured out that they had received Viagra, and that knowledge might have affected their assessment of their sexual performance, he said.
"This is a provocative study, but I would love to see it confirmed in a larger group of women," he said.
Nonetheless, Braunstein predicted that few women on antidepressants would wait for a second study.
"If I had to predict, use of Viagra will go up," he said. "A woman might not even ask her gynecologist for it -- she might just ask her significant other to give her some."
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denise.gellene@latimes.com
