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I too am an impotent failure so I've read a lot about this. Testosterone (and associated metabolites), dopamine, serotonin, acetylcholine, nitric oxide, and oxytocin seem to be the most relevant things. If viagra doesn't help then nitric oxide pathway probably isn't a problem. Testosterone is very easy to check. Besides that it's guesswork. Who knows, maybe you have an adrenal tumor producing excessive estradiol. You could be one of the less than 1000 people who have ever been reported to have that condition.
Of course I don't actually understand any of it because I don't have a degree in biology, much less pharmacology, much less neuro-biology, but I can tell you that even the smartest people in the world don't know and don't care about this condition. If you go to the urologist he'll just try to sell you a penile implant, which obviously won't even address the underlying problem. Psychological reasons are bullshit barring something extreme like you were raped or something and can't get over it. The situation is pretty bleak. Obviously if you're taking anti-depressants then they're very likely the cause.
