Switching to tianeptine in patients with antidepressant-induced sexual dysfunction.

Firat University, School of Medicine, Department of Psychiatry, Elazig, Turkey.
Human Psychopharmacology Clinical and Experimental (Impact Factor: 2.1). 07/2003; 18(4):277-80. DOI: 10.1002/hup.479
Source: PubMed

ABSTRACT Sexual side effects are frequent and are recently being considered as effects of antidepressant treatment. One method to improve the sexual dysfunction associated with the use of antidepressants is to change to another antidepressant. In the present work, the consequences of switching to tianeptine in patients with antidepressant-induced sexual dysfunction were studied. The study group comprised 23 patients with major depressive disorder who experienced antidepressant-induced sexual dysfunction. These antidepressants were stopped and switched to tianeptine (12.5mg x 3/day). All patients were screened by using the clinical global impression-improvement scale (CGI-I), the Hamilton depression rating scale (HAM-D) and the Arizona sexual experience scale (ASEX) at the beginning of the study, and at weeks 4 and 8. No patient failed to tolerate 37.5mg of tianeptine or to complete the study except for one patient becoming pregnant. Paired t-tests revealed a significant difference between baseline and week 4 or week 8 in scores on both the HAM-D and ASEX. At 8 weeks, six patients were rated as very much improved (CGI-I=1) and ten patients were rated as much improved (CGI-I=2). Thus, with a CGI-I score of 2 or less used to indicate a positive response, 72.7% of the patients were responders. The results suggest that switching to tianeptine appears to be useful for alleviating sexual dysfunction caused by other antidepressants.

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    ABSTRACT: Introduction.  Erectile dysfunction (ED) and depression are highly prevalent medical disorders affecting men of diverse cultures throughout the world. Tianeptine is a new antidepressant drug with less adverse effects on sexual functions.Aim.  To evaluate the efficacy of tianeptine in the treatment of mild to moderate depression with ED.Methods and Main Outcome Measures.  A randomized, double-blind, placebo-controlled, crossover trial. Subjects were assigned either tianeptine or matching placebo, each for 8 weeks. All patients were followed up on monthly basis where they were asked to complete three assessment questionnaires, namely, Anxiety and Depression Scale, Brief Sexual Inventory, and Quality-of-life and erection questionnaire. All patients were asked a global assessment question. Treatment-responsive subjects were defined as study participants who had scores 1–16 on the Anxiety and depression Scale, showed normal erectile function on the Brief Sexual Inventory, and answered “yes” to the global assessment question.Results.  Of the 237 consecutive men complaining of ED of >6 months and screened for this study, 110 patients met our inclusive criteria; 42 declined to participate. The remaining 68 patients were randomly assigned to treatment. Significant improvement (P < 0.05) was observed during the active drug phase in all three assessments questionnaires, in comparison with the placebo phase. Forty-eight patients (72.7%) of the subjects during the active drug phase were classified as responders, while 19 (27.9%) of the subjects during placebo phase were classified as responders.Conclusions.  Tianeptine could be considered an effective therapy for the treatment of depression and ED. Further large-scale multicentered studies are warranted. El-Shafey H, Atteya A, el-Magd SA, Hassanein A, Fathy A, and Shamloul R. Tianeptine can be effective in men with depression and erectile dysfunction. J Sex Med 2006;3:910–917.
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