Efficacy and Safety of Phosphodiesterase-5 Inhibitors for Erectile Dysfunction in Schizophrenia: A Systematic Review and Meta-Analysis
Abstract
Background: The benefits of phosphodiesterase-5 inhibitors in the treatment of sexual dysfunction and psychopathology of schizophrenia remain unclear. This systematic review and meta-analysis aimed to address the above clinical question.
Methods: Our primary outcome includes erectile dysfunction (ED) assessed using standardized questionnaires. Other efficacy outcomes involve overall sexual dysfunction, overall schizophrenia symptoms, positive symptoms, and negative symptoms. Further, we included all-cause discontinuation, discontinuation due to adverse events, discontinuation due to consent withdrawal, headache, loss of appetite, and somnolence. A meta-analysis was conducted for outcomes if at least two studies in each drug group had sufficient data to conduct a meta-analysis for a specific outcome.
Results: Our systematic review included five double-blind, randomized, placebo-controlled trials (n=155, mean age=37.18 years, male proportion=91.61%), consisting of one lodenafil, three sildenafil, and one tadalafil study. Among the three studies on sildenafil, only one reported outcomes on sexual dysfunction; however, it demonstrated that sildenafil improved ED in males with schizophrenia. Another study reported that sildenafil also outperformed placebo in terms of schizophrenia symptom improvement, especially negative symptoms. However, our meta-analysis revealed no significant differences in outcomes associated with psychopathology, all-cause discontinuation, discontinuation…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 155 participants or records.
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