Viagra for brain health? Here's what the experts think
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[There is] nothing convincing enough in humans to change clinical practice or prescribing patterns at this time.
—Tony Chen, MD
If we wanted to study ways to utilize [the drugs] differently, I'm all for it.
—Alan Shindel, MD
Research suggests that Viagra may have additional health benefits beyond erectile dysfunction (ED).[]
A study published in the World Journal of Men’s Health (WJMH) notes possible cardiovascular and metabolic benefits. It's also been called one of the "best existing options for treating Alzheimer's disease."
Related: Viagra may be one of our best existing options for treating Alzheimer's disease“Our review presents the evidence base showing the association of PDE5i and favourable clinical outcomes in the case of cardiovascular events, diabetes, and urological conditions such as LUTS and BPH, among others,” the WJMH authors write.[]
The researchers reviewed existing studies on phosphodiesterase 5 inhibitors (PDE5i). They identified that drugs like Viagra could assist with a number of conditions in addition to ED, including difficulties with urination, enlarged prostate, and stroke, in particular.
“It's important to also not see erectile dysfunction in a vacuum, that its presence is an early indicator of underlying vascular disease, and to use it as a motivational moment for patients to seek preventative care like getting established with a PCP [and] changing their diet [and] exercise levels,” Tony Chen, MD, a clinical assistant professor of urology at Stanford University School of Medicine, tells MDLinx.
New uses for Viagra
The research paper adds to a growing body of literature exploring potential new uses of PDE5i.
In 2024, Oxford University researchers found that sildenafil (Viagra) improves blood flow to the brain and endothelial function of blood vessels in the brain in patients with an increased risk of vascular dementia.[]
“This is the first trial to show that sildenafil gets into the blood vessels in the brain in people with this condition, improving blood flow and how responsive these blood vessels are. These two key factors are associated with chronic damage to the small blood vessels in the brain, which is the commonest cause of vascular dementia. This demonstrates the potential of this well-tolerated, widely-available drug to prevent dementia, which needs testing in larger trials,” Alastair Webb, MD, lead author of the study and an associate professor at the Wolfson Centre for Prevention of Stroke and Dementia at Oxford University, said in a press release.[]
Not enough evidence to change clinical practice
But experts who spoke with MDLinx say there is not enough evidence to support the use of Viagra for neurological purposes.
“[I’m] not convinced at this time that it is appropriate to use [Viagra] for treating or preventing vascular dementia—but the potential mechanism of why it may work has to do with improving endothelial function. It would be more useful to address some of the upstream causes of both erectile dysfunction and vascular dementia and focus on prevention in an ideal world,” Dr. Chen says.
“There are some animal studies that suggest some potential benefits of PDE5i on cognitive and neuronal function. But [there is] nothing convincing enough in humans to change clinical practice or prescribing patterns at this time.” —Tony Chen, MD
However, Dr. Chen says, drugs like Viagra can still offer meaningful benefits.
“I try to emphasize that Viagra is safe and effective in the treatment of erectile dysfunction. Some patients shun it due to thinking it's a ‘Band-Aid approach’ and would like to address the underlying cause. However, the underlying cause is typically years of chronic hypertension, hyperlipidemia, and poor glycemic control that no treatment can really reverse. I encourage its use in combination with lifestyle changes,” Dr. Chen says.
Alan Shindel, MD, a professor of urology at the University of California, San Francisco, says now that with drugs like Viagra, which are off-patent and can be produced cheaply, more research opportunities into PDE5i could be possible.
“If we wanted to study ways to utilize [the drugs] differently, I'm all for it. It's just a matter of getting the funding to do the proper kind of studies to definitively prove that these drugs are having these beneficial effects for nonurologic indications,” Dr. Shindel says.
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