Antidepressant-Induced Sexual Dysfunction among Newer Antidepressants in a Naturalistic Setting

Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Psychiatry investigation (Impact Factor: 1.28). 03/2010; 7(1):55-9. DOI: 10.4306/pi.2010.7.1.55
Source: PubMed


Antidepressants used to treat depression are frequently associated with sexual dysfunction. Sexual side effects affect the patient's quality of life and, in long-term treatment, can lead to non-compliance and relapse. However, studies covering many antidepressants with differing mechanisms of action were scarce. The present study assessed and compared the incidence of sexual dysfunction among different antidepressants in a naturalistic setting.
Participants were married patients diagnosed with depression, per DSM-IV diagnostic criteria, who had been taking antidepressants for more than 1 month. We assessed the participants via the Arizona Sexual Experiences Scale (ASEX), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI), and assessed their demographic variables, types and dosages of antidepressants, and duration of antidepressant use via their medical records.
One hundred and one patients (46 male, 55 female, age 42.2+/-7 years) completed the instruments. Thirteen were taking fluoxetine (mean dose 21.3+/-8.5 mg/day), 24 were taking paroxetine (mean dose 20.4+/-7.2 mg/day), 20 taking citalopram (mean dose 22.1+/-6.5 mg/day), 22, venlafaxine (mean dose 115.7+/-53.2 mg/day) and 22, mirtazapine (mean dose 18+/-8.7 mg/day). Mean ages, sex ratios, and BDI and STAI scores did not differ significantly across antidepressants. A substantial number of participants (46.5%, n=47) experienced sexual dysfunction. The prevalence of sexual dysfunction differed across drugs: citalopram 60% (n=12), venlafaxine 54.5% (n=12), paroxetine 54.2% (n=13), fluoxetine 46.2% (n=6), and mirtazapine 18.2% (n=4). Regression analyses revealed the significant factors for sexual dysfunction were being female, total scores on the BDI and SAI, and type of antidepressant (F=4.92, p<0.0001). Of the antidepressants, the mirtarzapine group's total ASEX score was significantly lower than the scores of the citalopram, fluoxetine, and paroxetine groups.
The incidence of sexual dysfunction was substantially high during antidepressant treatment. The incidence of sexual dysfunction differed among antidepressants having different mechanisms of action. Our study suggests the need for clinicians to consider the impact of pharmacotherapy on patients' sexual functioning in the course of treatment with antidepressants.

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    • "rease in HR of 8 . 5 bpm compared with 1 . 7 bpm in the placebo group . In addition , a loss of ≥5% or more of body weight occurred in 7% of patients treated with venlafaxine compared to 2% of patients treated with placebo ( Wyeth Phar - maceuticals , Inc , 2012 ) . Finally , sexual dysfunction has been noted in patients treated with venlafaxine ( Lee et al . , 2010 ; Schweitzer , Maguire , & Ng , 2009 ) . Abrupt discontinuation has been found to be associated with the appearance of a variety of new symptoms ( Wyeth Pharma - ceuticals , Inc , 2012 ) ."

    Full-text · Article · Jan 2013 · Open Journal of Depression
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    • "The SSRIs and venlafaxine resulted in the highest rates of dysfunction. Comparable rates of sexual dysfunction have been found in a more recent study [34]. There is even evidence that some patients may experience genital anesthesia or pleasureless orgasm, a problem that for some patients may persist even after the medication is discontinued [32]. "
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