Future of Central Drugs in Erectile Dysfunction

Male erectile dysfunction (ED) increases with aging and affects millions of men around the world. Over the last two decades different physiological mechanisms regulating penile erection at local level and, to a lesser extent, at central level, have been identified and characterized. These findings led to the discovery of drugs that act peripherally and centrally revealing different possible therapeutic strategies for ED. This chapter is aimed at reviewing centrally acting drugs and molecular targets suitable for the therapy of ED. Particular attention is given to the most recently discovered molecular targets involved in the control of erectile responses at central level. Drugs that act on these new targets might represent future therapeutic strategies for ED. Among these drugs, the most promising from the now available experimental data, belong to the family of dopamine receptor agonists (mainly D4 receptor agonists) and to the family of melanocortin receptor agonists.