Viagra or Placebo: Surprising Results From a New Study

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It's been known for years that PDE5 inhibitors, Viagra, Cialis, Levitra, improve erectile function in men. However, a surprising number of men in a double-blind, controlled study of sildenafil (Viagra) responded well - better than expected - to placebo as opposed to the active drug. These men reported improved erectile function as measured by International Index of Erectile Function (IIEF)–Erectile Function Domain (EFD) scores. placebo.jpg



Methods


Placebo-treated participants in the intent-to-treat population of 42 double-blind, placebo-controlled, flexible-dose, sildenafil studies were included. A participant was classified as a placebo responder if the International Index of Erectile Function-EFD score was ≥26 at the last visit.


Outcomes

Variables assessed were:

  • age (<45, 45&#8211;64, &#8805;65 years),
  • race,
  • body mass index,
  • co-morbidities (cardiovascular disease/hypertension, diabetes mellitus, depression),
  • date the last study dose was taken,
  • study completion date,
  • ED etiology (psychogenic, organic, mixed),
  • history of cigarette smoking,
  • ED duration, baseline IIEF-EFD score (&#8804;10, 11&#8211;16, &#8805;17),
  • and treatment duration.


Results


  • A total of 4,360 men were included; 13.5% were responders.
  • Odds estimates indicated the largest likelihood of placebo response occurred in men who were black (odds = 20.2, P < .0001), were younger than 45 years (odds = 7.3, P < .0001), had mild ED (baseline IIEF-EFD &#8805;17; odds >100, P < .0001), and did not have diabetes (odds = 4.5, P < .0001).
  • The likelihood of a placebo response decreased as ED duration increased (odds = 0.74, P < .0001).
  • The frequency of common adverse events was similar between placebo responders and non-responders.


Conclusions


Certain demographics, co-morbidities, and condition characteristics predicted the odds of a placebo response in sildenafil clinical studies of ED. Underlying reasons behind a placebo response warrant further evaluation. The strong role psychological factors play in ED presentation, even in cases with an underlying organic foundation, can not be overlooked.

"Predictors of Erectile Function Normalization in Men With Erectile Dysfunction Treated With Placebo," Journal of Sexual Medicine, In press, May 2018, https://www.jsm.jsexmed.org/action/...095(18)30934-2&doi=10.1016/j.jsxm.2018.03.089
 
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#4
I would have not done well in that test. Suffering from the side effects from low dose Cialis (stuffy nose and chronic lower back pain)
I have tested the big three over the last 3 months and tried to find just how low a dose I could use.
My findings suck for me. If I want a stiffy once or twice a week I must suffer with lower back pain 24/7 Nose spray keeps the stuffy nose away.
Nothing has worked on the lower back pain other than stop taking it.
 
#6
At every step of the way since before I was diagnosed and then in treating my hypogonadism everything was always blamed on psychology and my concerns have routinely been dismissed and I go away thinking that the doctors know better and I'm left with trying to figure out whats wrong with me as a person. It's freaking neurotic. And it turned out I had undiagnosed hypogonadism for 16 years and then once diagnosed those GPs had no understanding at all of how to do TRT even though they were so sure they did. And I suffered a lot while being treated like some loser. I'm so glad I finally have enough information and know how to look into things myself and find the doctors I need. Now I'm so much better and it didn't happen because I had a brain transplant. Serious ED is not even close to ever being MOSTLY psychological unless maybe you have like some severe trauma or something? Sure it's a factor and maybe more for some than others, but not a cure or cause of a real health problem. But that doesn't stop everyone and their doctor from thinking its psychological. That's the answer for everything people don't have a solution for. Fun stuff to deal with.
 
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