Erectile dysfunction (ED) is not uncommon in male patients with schizophrenia. The illness itself and antipsychotic medications (typical and atypical) have been implicated. Hyperprolactinemia due to pituary D2 blockade is a probable causative factor for ED but adrenergic α1 blockade and anticholinergic activity of neuroleptic drugs in the periphery have also been involved. The availability of three phosphodiesterase-5 (PDE-5) inhibitors, sildenafil, vardenafil, and tadalafil, has altered the management of ED. The aim of the study was to investigate the role of PDE-5 inhibitors in schizophrenic patients with ED

A search was performed in MEDLINE database using the following keywords: ‘erectile dysfunction’, ‘schizophrenia’, ‘phosphodiesterase-5 inhibitors’.

There exist positive reports with sildenafil regarding the role of PDE-5 inhibitors in schizophrenic patients with ED, and only one double-blind, placebo-controlled study. A recent open-label study with vardenafil has confirmed the beneficial effects of PDE-5 inhibitors on patients with chronic schizophrenia.

PDE-5 inhibitors have been shown effective for ED in individuals with schizophrenia. However, the number of studies is small and further investigation is needed to confirm the, up to the present, positive findings.