SSRI-induced sexual dysfunction : clinical study of 344 patients

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" In only 5.8% of patients, the dysfunction disappeared completely

within 6 months "

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Titre du document / Document title

SSRI-induced sexual dysfunction : Fluoxetine, paroxetine, sertraline,

and fluvoxamine in a prospective, multicenter, and descriptive

clinical study of 344 patients

Auteur(s) / Author(s)

MONTEJO-GONZALEZ A. L. (1) ; LLORCA G. ; IZQUIERDO J. A. ; LEDESMA A.

; BOUSONO M. ; CALCEDO A. ; CARRASCO J. L. ; CIUDAD J. ; DANIEL E. ;

DE LA GANDARA J. ; DERECHO J. ; FRANCO M. ; GOMEZ M. J. ; MACIAS J. A.

; MARTIN T. ; PEREZ V. ; SANCHEZ J. M. ; SANCHEZ S. ; VICENS E. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Servicio de Psiquiatria, Hospital Universitario de Salamanca,

Paseo de S. Vicente 58, 37007 Salamanca, ESPAGNE

Résumé / Abstract

The authors analyzed the incidence of sexual dysfunction (SD) with

different selective serotonin reuptake inhibitors (SSRIs; fluoxetine,

fluvoxamine, paroxetine, and sertraline) and hence the qualitative and

quantitative changes in SD throughout time in a prospective and

multicenter study. Outpatients (192 women and 152 men; age = 39.6±11.4

years) under treatment with SSRIs were interviewed with an SD

questionnaire designed for this purpose by the authors and that

included questions about the following: decreased libido, delayed

orgasm or anorgasmia, delayed ejaculation, inability to ejaculate,

impotence, and general sexual satisfaction. Patients with the

following criteria were included: normal sexual function before SSRI

intake, exclusive treatment with SSRIs or treatment associated with

benzodiazepines, previous heterosexual or self-erotic current sexual

practices. Excluded were patients with previous sexual dysfunction,

association of SSRIs with neuroleptics, recent hormone intake, and

significant medical illnesses. There was a significant increase in the

incidence of SD when physicians asked the patients direct questions

(58%) versus when SD was spontaneously reported (14%). There were some

significant differences among different SSRIs: paroxetine provoked

more delay of orgasm or ejaculation and more impotence than

fluvoxamine, fluoxetine and sertraline (X[2], p <.05). Only 24.5% of

the patients had a good tolerance of their sexual dysfunction. Twelve

male patients who suffered from premature ejaculation before the

treatment preferred to maintain delayed ejaculation, and their sexual

satisfaction, and that of their partners, clearly improved. Sexual

dysfunction was positively correlated with dose. Patients experienced

substantial improvement in sexual function when the dose was

diminished or the drug was withdrawn. Men showed more incidence

ofsexual dysfunction than women, but women's sexual dysfunction was

more intense than men's. In only 5.8% of patients, the dysfunction

disappeared completely within 6 months, but 81.4% showed no

improvement at all by the end of this period. Twelve of 15 patients

experienced total improvement when the treatment was changed to

moclobemide (450-600 mg/day), and 3 of 5 patients improved when

treatment was changed to amineptine (200 mg/day).

Revue / Journal Title

Journal of sex and marital therapy (J. sex marital ther.) ISSN

0092-623X CODEN JSMTB5

Source / Source

1997, vol. 23, no3, pp. 176-194 (130 ref.)

Langue / Language

Anglais

Editeur / Publisher

Human Sciences Press, New York, NY, ETATS-UNIS (1974) (Revue)

Mots-clés anglais / English Keywords

Fluoxetine ; Paroxetine ; Sertraline ; Fluvoxamine ; Incidence ;

Epidemiology ; Public health ; Toxicity ; Chemotherapy ; Treatment ;

Sexual behavior disorder ; Multicenter study ; Sex ; Human ;

Antidepressant agent ; Psychotropic ; Reuptake inhibitor ; Serotonin ;

Mots-clés français / French Keywords

Fluoxétine ; Paroxétine ; Sertraline ; Fluvoxamine ; Incidence ;

Epidémiologie ; Santé publique ; Toxicité ; Chimiothérapie ;

Traitement ; Trouble comportement sexuel ; Etude multicentrique ; Sexe

; Homme ; Antidépresseur ; Psychotrope ; Inhibiteur recapture ;

Sérotonine ;

Mots-clés espagnols / Spanish Keywords

Fluoxetina ; Paroxetina ; Sertralina ; Fluvoxamina ; Incidencia ;

Epidemiología ; Salud pública ; Toxicidad ; Quimioterapia ;

Tratamiento ; Trastorno conducta sexual ; Estudio multicéntrico ; Sexo

; Hombre ; Antidepresor ; Psicotropo ; Inhibidor recaptura ; Serotonina ;

Localisation / Location

INIST-CNRS, Cote INIST : 15755, 35400006921556.0020

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Nº notice refdoc (ud4) : 2799162