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Although treatments are usually effective for managing thyroid function, individual genetic, environmental, or lifestyle factors that affect disease outcome and/or response to therapy are generally ignored

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Pro-inflammatory cytokines frequently elevated in psoriasis, including TNF-, IFN-, IL-1, and IL-6, are recognized for their ability to inhibit serotonin synthesis while increasing CRH levels, potentially associating psoriasis with the onset of depressive symptoms and increased vulnerability to stress (Rousset and Halioua 2018)

Use of sildenafil for this indication is supported by evidence from adequate and well-controlled studies in adults with additional PK and safety data in pediatric patients aged 1 year and older [see Adverse Reactions (6.1), Clinical Studies (14)]