Incidence of sexual dysfunction associated with antidepressant agents

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Incidence of sexual dysfunction associated with antidepressant agents:

a prospective multicenter study of 1022 outpatients. Spanish Working

Group for the Study of Psychotropic-Related Sexual Dysfunction.

Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F.

University Hospital of Salamanca, Psychiatric Teaching Area,

University of Salamanca, School of Medicine, Spain.

angelluis.montejo@...

BACKGROUND: Antidepressants, especially selective serotonin reuptake

inhibitors (SSRIs), venlafaxine, and clomipramine, are frequently

associated with sexual dysfunction. Other antidepressants (nefazodone,

mirtazapine, bupropion, amineptine, and moclobemide) with different

mechanisms of action seem to have fewer sexual side effects. The

incidence of sexual dysfunction is underestimated, and the use of a

specific questionnaire is needed. METHOD: The authors analyzed the

incidence of antidepressant-related sexual dysfunction in a

multicenter, prospective, open-label study carried out by the Spanish

Working Group for the Study of Psychotropic-Related Sexual

Dysfunction. The group collected data from April 1995 to February 2000

on patients with previously normal sexual function who were being

treated with antidepressants alone or antidepressants plus

benzodiazepines. One thousand twenty-two outpatients (610 women, 412

men; mean age = 39.8 +/- 11.3 years) were interviewed using the

Psychotropic-Related Sexual Dysfunction Questionnaire, which includes

questions about libido, orgasm, ejaculation, erectile function, and

general sexual satisfaction. RESULTS: The overall incidence of sexual

dysfunction was 59.1% (604/1022) when all antidepressants were

considered as a whole. There were relevant differences when the

incidence of any type of sexual dysfunction was compared among

different drugs: fluoxetine, 57.7% (161/279); sertraline, 62.9%

(100/159); fluvoxamine, 62.3% (48/77); paroxetine, 70.7% (147/208);

citalopram, 72.7% (48/66); venlafaxine, 67.3% (37/55); mirtazapine,

24.4% (12/49); nefazodone, 8% (4/50); amineptine, 6.9% (2/29); and

moclobemide, 3.9% (1/26). Men had a higher frequency of sexual

dysfunction (62.4%) than women (56.9%), although women had higher

severity. About 40% of patients showed low tolerance of their sexual

dysfunction. CONCLUSION: The incidence of sexual dysfunction with

SSRIs and venlafaxine is high, ranging from 58% to 73%, as compared

with serotonin-2 (5-HT2) blockers (nefazodone and mirtazapine),

moclobemide, and amineptine.

PMID: 11229449 [PubMed - indexed for MEDLINE]