Sexual compulsive behaviors, ED drug misuse linked

November 1, 2006

Boston-A study investigating a treatment sample of men diagnosed with sexual compulsivity suggests that prescription and non-prescription use of phosphodiesterase type-5 inhibitors is common in that population. This finding should alert physicians who prescribe medications for erectile dysfunction to maintain an index of patients with a suspected sexual compulsivity problem and to be attentive to clues of potential drug misuse, according to the researchers.

The study was reported at the 2006 American College of Clinical Pharmacology annual meeting. It included 41 men with a diagnosis of sexual compulsivity who were being admitted to Pine Grove Addiction Treatment Centers, Hattiesburg, MS. When queried about use of any of the PDE-5 inhibitors indicated for the treatment of ED, almost half of the men (20 of 41) reported currently using such medication. Half of those individuals indicated that they had a prescription for the drug, while the rest had obtained the agent through other means.

Dr. Gold and his collaborators began this investigation when information obtained during admission interviews of men with compulsive sexual behavior entering the Pine Grove treatment program suggested ED misuse was prevalent.

"There is a recognized epidemic in this country of prescription medication misuse, and epidemiological studies have described problems with methylphenidate, prescription pain, and even antidepressant medications. Medications for ED have not been included in these national monitoring surveys, although it is known that men without ED and patients with a history of methylenedioxymethamphetamine ("ecstasy") or methamphetamine abuse use ED drugs as performance enhancers," Dr. Gold said.

The study investigating men newly admitted to the treatment center excluded any individuals with a disease or diagnosis that would qualify them to be given a prescription for a PDE-5 inhibitor. Nearly all of the men were white (95%); the rest were Hispanic. They ranged in age from 21 to 66 years old; however, the mean age was 42 years, and eight of the men who were using an ED drug (40%) were under 40 years of age.

Of the 10 men who obtained their ED medication with a prescription, one admitted to having written the prescription himself. Six men (30%) reported obtaining the drug "off the street," three (15%) men purchased the medication on the Internet, and one (5%) stated that he had obtained the medication from a friend.

Multiple drugs

A query about the specific drug(s) being used revealed that 12 men (60%) were using only sildenafil citrate (Viagra). The rest of the men were also using sildenafil, but in combination with tadalafil (Cialis) and/or vardenafil (Levitra).

Investigators are continuing their research into whether ED medication misuse also exists among individuals who are abusing other drugs of abuse and prescription medications.