New treatment for erectile dysfunction.

Numerous advances have been made in our understanding of the evaluation and treatment of erectile dysfunction. Numerous treatment options are currently available. Treatment of this disorder was revolutionized by the introduction of sildenafil, an oral vasoactive agent that has a peripheral mechanism of action, blocking the degradation of cyclic guanosine monophosphate, and thus augmenting the erectogenic effect of sexual stimulation. This agent has proven efficacy in a variety of patient populations, including psychiatric patients. Clinical series suggest that this agent will reverse erectile dysfunction induced by psychoactive agents. Thus, it may play a role in decreasing treatment noncompliance associated with drug-induced sexual dysfunction. Another novel agent that is in development may be of special interest to psychiatrists. Apomorphine is a central dopamine agonist that is believed to act at the level of the paraventricular nucleus of the hypothalamus. As new agents are evolving, our understanding of the neurobiology of sexual function is advancing.