OBJECTIVE: Depressed men commonly have erectile dysfunction, and men with erectile dysfunction are frequently depressed. Since the etiologic and modulatory relationships between depression and erectile dysfunction have been poorly characterized, a 12-week, randomized, double-blind, placebo-controlled trial was conducted at 20 urologic clinics to evaluate the effects of sildenafil treatment in men with erectile dysfunction and mild-to-moderate comorbid depressive illness. METHOD: Men (N=152, mean age=56 years) with erectile dysfunction for =" src="/math/ge.gif"6 months (mean=5.7 years), a DSM-IV diagnosis of depressive disorder not otherwise specified, and a Hamilton Depression Rating Scale score =" src="/math/ge.gif"12 (mean at baseline=16.9) were randomly assigned to flexible-dose treatment with sildenafil citrate or matching placebo. Interviewer-rated and self-report instruments were used to assess changes in sexual function, depressive symptoms, and quality of life. Conservative criteria were used to classify erectile dysfunction treatment response and nonresponse. RESULTS: Sildenafil was strongly associated with erectile dysfunction treatment response. Fifty-eight men met the conservative criteria for response (48 given sildenafil, 10 given placebo), and 78 men did not respond (18 given sildenafil, 60 given placebo). Mean decreases of 10.6 and 2.3 in Hamilton depression scale scores were seen in treatment responders and nonresponders, respectively; 76% of treatment responders showed a =" src="/math/ge.gif"50% decline in Hamilton depression scale score versus 14% of nonresponders. Quality of life was similarly improved in treatment responders. CONCLUSIONS: Sildenafil is efficacious for erectile dysfunction in men with mild-to-moderate depressive illness. Improvement of erectile dysfunction is associated with marked improvement in depressive symptoms and quality of life. best deal cialis online cialis online erectile dysfunction cialis pills buy cialis online click to enter pharmacy buy cialis Have you recently had surgery? click to enter pharmacy viagra Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are medicines prescribed for erection difficulties caused by either physical or psychological problems. The drugs work only when the man is sexually aroused. The effect is usually seen within 15 - 45 minutes. dUS R&D, Clinical Development, Pharmacia & Upjohn, Kalamazoo, Mich., USA; buy viagra online canada viagra canadian pharmacy The authors declare no conflicting financial interests.