The aim of the work was to assess the degree of anxiety and depression in non organic erectile dysfunction (ED), to evaluate the effect of Tianeptine on sexual function in patients with ED due to depression and to evaluate the effect of Tianeptine on the quality of life in patients with ED due to depression. Full history, examination, intracorporeal injection (ICI) test and laboratory investigations were done to exclude cases with suspected organic aetiology. O’Leary’s sexual inventory scale, EL Rakhawy and Shaheen’s anxiety and depression scale and Wagner’s Quality of life and erection questionnaire were applied to all patients initially and monthly throughout the study. All patients received Tianeptine (37.5 mg daily orally) for two months and placebo for two month, crossover was done over the following two months. The results of the study can be summarized as follows: although there was an overall improvement in all mean scores with the drug and deterioration with placebo, some patients deteriorated and some patients showed no change in their scores. In conclusion, Andrologists should check for depression and anxiety by standard scales before performing NPTR monitoring and delay the tests if high scores are found to avoid false negative results. Sexual dysfunction improves secondary to improvement of depression when using a drug of the new generation of antidepressants which include Tianeptine. Tianeptine is associated with low incidence of sexual dysfunction and so it is one of the new antidepressants recommended for depression associated with sexual dysfunction and for drug switching strategies in the treatment of antidepressant induced sexual dysfunction.