Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Effects of repeated dosing with Udenafil (Zydena) on cognition, somatization and erection in patients with erectile dysfunction: a pilot study

International Journal of Impotence Research volume 23, pages 109–114 (2011)Cite this article

Subjects

Abstract

The PDE5 inhibitors have recently been found to have cognitive-enhancing effects in animal models. To investigate the efficacy of repeated dosing with a PDE5 inhibitor on cognitive function and somatization in patients with erectile dysfunction, 27 patients with erectile dysfunction received udenafil (100 mg) at 3-day intervals for 2 months. The international index of erectile function-5 (IIEF-5), a cognitive battery (the Korean version of mini-mental state examination (K-MMSE), the frontal assessment battery (K-FAB), the Seoul verbal learning test) and a physical health questionnaire-15 (PHQ-15) were performed at baseline and at 2 months, following the administration of udenafil. The patients were divided on the basis of their IIEF-5 score into responders (change>7) and non-responders. The mean IIEF-5 score was significantly increased after treatment (7.92±3.83 to 16.33±4.75, P<0.001). The scores of K-MMSE (27.03±1.58 to 28.07±1.57, P=0.001), K-FAB (13.65±1.96 to 15.41±1.85, P<0.001) and PHQ-15 (18.92±4.96 to 17.63±4.75, P=0.003) were significantly improved after treatment. In addition, the responders (n=16) had more improved cognitive function (r=0.603, P=0.001) and somatization (r=−0.402, P=0.038) than non-responders (n=11). Repeated dosing with a PDE5 inhibitor seems to improve cognitive function and somatization, as well as erectile function in patients with erectile dysfunction.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Ballard SA, Gingell CJ, Tang K, Turner LA, Price ME, Naylor AM . Effects of sildenafil on the relaxation of human corpus cavernosum tissue in vitro and on the activities of cyclic nucleotide phosphodiesterase isozymes. J Urol 1998; 159: 2164–2171.

    Article  CAS  Google Scholar 

  2. Rosen RC, Kostis JB . Overview of phosphodiesterase 5 inhibition in erectile dysfunction. Am J Cardiol 2003; 92: 9M–18M.

    Article  CAS  Google Scholar 

  3. Salem EA, Kendirci M, Hellstrom WJ . Udenafil, a long-acting PDE5 inhibitor for erectile dysfunction. Curr Opin Investig Drugs 2006; 7: 661–669.

    CAS  PubMed  Google Scholar 

  4. Paick JS, Kim SW, Yang DY, Kim JJ, Lee SW, Ahn TY et al. The efficacy and safety of udenafil, a new selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction. J Sex Med 2008; 5: 946–953.

    Article  CAS  Google Scholar 

  5. Stehlik J, Movsesian MA . Combined use of PDE5 inhibitors and nitrates in the treatment of pulmonary arterial hypertension in patients with heart failure. J Card fail 2009; 15: 31–34.

    Article  CAS  Google Scholar 

  6. Giannitsas K, Mitropoulos D, Konstantinopoulos A, Athanasopoulos A, Perimenis P . Phosphodiesterase-5 inhibitors in the treatment of lower urinary tract symptoms and benign prostatic hyperplasia. Expert Opin Pharmacother 2008; 9: 1687–1693.

    Article  CAS  Google Scholar 

  7. Bednar MM . The role of sildenafil in the treatment of stroke. Curr Opin Investig Drugs 2008; 9: 754–759.

    CAS  PubMed  Google Scholar 

  8. van Staveren WC, Markerink-van Ittersum M . Localization of cyclic guanosine 3′,5′-monophosphate-hydrolyzing phosphodiesterase type 9 in rat brain by nonradioactive in situ hybridization. Methods Mol Biol 2005; 307: 75–84.

    CAS  PubMed  Google Scholar 

  9. Zhang R, Wang Y, Zhang L, Zhang Z, Tsang W, Lu M et al. Sildenafil (Viagra) induces neurogenesis and promotes functional recovery after stroke in rats. Stroke 2002; 33: 2675–2680.

    Article  CAS  Google Scholar 

  10. Erceg S, Monfort P, Hernández-Viadel M, Rodrigo R, Montoliu C, Felipo V . Oral administration of sildenafil restores learning ability in rats with hyperammonemia and with portacaval shunts. Hepatology 2005; 41: 299–306.

    Article  CAS  Google Scholar 

  11. Prickaerts J, de Vente J, Honig W, Steinbusch HW, Blokland A . cGMP, but not cAMP, in rat hippocampus is involved in early stages of object memory consolidation. Eur J Pharmacol 2002; 436: 83–87.

    Article  CAS  Google Scholar 

  12. Yamada K, Hiramatsu M, Noda Y, Mamiya T, Murai M, Kameyama T et al. Role of nitric oxide and cyclic GMP in the dizocilpine-induced impairment of spontaneous alternation behavior in mice. Neuroscience 1996; 74: 365–374.

    Article  CAS  Google Scholar 

  13. Prickaerts J, van Staveren WC, Sik A, Markerink-van Ittersum M, Niewöhner U, van der Staay FJ et al. Effects of two selective phosphodiesterase type 5 inhibitors, sildenafil and vardenafil, on object recognition memory and hippocampal cyclic GMP levels in the rat. Neuroscience 2002; 113: 351–361.

    Article  CAS  Google Scholar 

  14. Patil CS, Singh VP, Kulkarni SK . Modulatory effect of sildenafil in diabetes and electroconvulsive shock-induced cognitive dysfunction in rats. Pharmacol Rep 2006; 58: 373–380.

    CAS  PubMed  Google Scholar 

  15. Devan BD, Pistell PJ, Daffin Jr LW, Nelson CM, Duffy KB, Bowker JL et al. Sildenafil citrate attenuates a complex maze impairment induced by intracerebroventricular infusion of the NOS inhibitor Nomega-nitro-L-arginine methyl ester. Eur J Pharmacol 2007; 563: 134–140.

    Article  CAS  Google Scholar 

  16. Goff DC, Cather C, Freudenreich O, Henderson DC, Evins AE, Culhane MA et al. A placebo-controlled study of sildenafil effects on cognition in schizophrenia. Psychopharmacology (Berl) 2009; 202: 411–417.

    Article  CAS  Google Scholar 

  17. Corporate author: NIH. NIH Consensus Conference. NIH consensus development panel on impotence. JAMA 1993; 270: 83–90.

    Article  Google Scholar 

  18. Rhoden EL, Telöken C, Sogari PR, Vargas Souto CA . The use of the simplified international index of erectile function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res 2002; 14: 245–250.

    Article  CAS  Google Scholar 

  19. Kroenke K, Spitzer RL, Williams JB . The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 2002; 64: 258–266.

    Article  Google Scholar 

  20. Interian A, Allen LA, Gara MA, Escobar JI, Diaz-Martinez AM . Somatic complaints in primary care: further examining the validity of the Patient Health Questionnaire (PHQ-15). Psychosomatics 2006; 47: 392–398.

    Article  Google Scholar 

  21. Jeong SK, Cho KH, Kim JM . The usefulness of the Korean version of modified Mini-Mental State Examination (K-mMMSE) for dementia screening in community dwelling elderly people. BMC Public health 2004; 4: 31.

    Article  Google Scholar 

  22. Chey J, Kim JW, Cho HY . Hormone replacement therapy in postmenopausal women with Alzheimer′s disease: a randomized, prospective study. Neurosci Lett 2000; 289: 230–234.

    Article  CAS  Google Scholar 

  23. Kim TH, Huh Y, Choe JY, Jeong JW, Park JH, Lee SB et al. Korean version of frontal assessment battery: psychometric properties and normative data. Dement Geriatr Cogn Disord 2010; 29: 363–370.

    Article  Google Scholar 

  24. Hogervorst E, Combrinck M, Lapuerta P, Rue J, Swales K, Budge M . The Hopkins verbal learning test and screening for dementia. Dement Geriatr Cogn Disord 2002; 13: 13–20.

    Article  Google Scholar 

  25. Rutten K, Van Donkelaar EL, Ferrington L, Blokland A, Bollen E, Steinbusch HW et al. Phosphodiesterase inhibitors enhance object memory independent of cerebral blood flow and glucose utilization in rats. Neuropsychopharmacology 2009; 34: 1914–1925.

    Article  CAS  Google Scholar 

  26. Arnavaz A, Aurich A, Weissenborn K, Hartmann U, Emrich HM, Schneider U . Effect of sildenafil (Viagra) on cerebral blood flow velocity: a pilot study. Psychiatry Res 2003; 122: 207–209.

    Article  CAS  Google Scholar 

  27. Hatzichristou D, Cuzin B, Martin-Morales A, Buvat J, Porst H, Laferriere N . Vardenafil improves satisfaction rates, depressive symptomatology, and self-confidence in a broad population of men with erectile dysfunction. J Sex Med 2005; 2: 109–116.

    Article  CAS  Google Scholar 

  28. Rosen R, Shabsigh R, Berber M, Assalian P, Menza M, Rodriguez-Vela L . Efficacy and tolerability of vardenafil in men with mild depression and erectile dysfunction: the depression-related improvement with vardenafil for erectile response study. Am J Psychiatry 2006; 163: 79–87.

    Article  Google Scholar 

  29. Christensen H, Griffiths K, Mackinnon A, Jacomb P . A quantitative review of cognitive deficits in depression and Alzheimer-type dementia. J Int Neuropsychol Soc 1997; 3: 631–651.

    CAS  PubMed  Google Scholar 

  30. Althof SE, Berner MM, Goldstein I, Claes HI, Cappelleri JC, Bushmakin AG et al. Interrelationship of sildenafil treatment effects on the physiological and psychosocial aspects of erectile dysfunction of mixed or organic etiology. J Sex Med 2010; 7: 3170–3178.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea

    Y S Shim

  2. Department of Psychiatry, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea

    C-U Pae

  3. Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea

    S W Kim

  4. Department of Urology, The Catholic University of Korea, St. Paul's Hospital, Seoul, Korea

    H W Kim

  5. Department of Urology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea

    J C Kim & J S Koh

Authors
  1. Y S Shim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C-U Pae
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S W Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H W Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J C Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J S Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J S Koh.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shim, Y., Pae, CU., Kim, S. et al. Effects of repeated dosing with Udenafil (Zydena) on cognition, somatization and erection in patients with erectile dysfunction: a pilot study. Int J Impot Res 23, 109–114 (2011). https://doi.org/10.1038/ijir.2011.13

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2011.13

Keywords

This article is cited by

Search

Advanced search

Quick links