2012, Number 1
PDF size: 305.72 Kb.
ABSTRACTAntidepressant treatment, although effective in treating the manifestations of major depression, may also be able to induce or exacerbate some symptoms of sexual dysfunction, these symptoms negatively affect quality of life of the person who suffers, his self-esteem and can lead to lack of adherence to treatment and subsequent relapse of depressive symptoms. The objectives of this review are to assess the frequency of sexual dysfunction associated with antidepressant treatment, an update on the range of adverse effects on sexuality associated with different antidepressants, analyze which ones are most associated with this problem and which are relatively “noble” in this regard, also provide some recommendations for treatment, both pharmacological and nonpharmacological to counter this adverse effect of antidepressant drugs.
Masters WH, Johnson VE. Human sexual response. Boston, Mass; Little Brown and Co., 1966.
Kaplan HS. Disorders of sexual desire. New York, NY: Bruner/Mazel Inc., 1979.
Mass General Hospital Psychiatry. Sexual disorders and Sexual Dysfunction, 2005.
Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281(6): 537-544.
Ernst C, Földényi M, Angst J. The Zurich Study: XXI. Sexual dysfunctions and disturbances in young adults. Data of a longitudinal epidemiological study. Eur Arch Psychiatry Clin Neurosci 1993; 243(3-4): 179-188.
Rosenberg KP, Bleiberg KL, Koscis J et al. A survey of sexual side effects among severely mentally ill patients taking psychotropic medications: impact on compliance. J Sex Marital Ther 2003; 29: 289-296.
Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: A prospective multicenter study of 1,022 outpatients. Spanish working group for the study of psychotropic-related sexual dysfunction. J Clin Psychiatry 2001; 62(Suppl 3): 10-21.
Keltner NL, McAfee KM, Taylor CL. Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspect Psychiatr Care 2002; 38: 111-116.
Harrison WM, Rabkin JG, Ehrhardt AA, Wtewart JW et al. Effects of antidepressant medication on sexual function: A controlled study. J Clin Psychopharmacol 1986; 6: 144-149.
Crenshaw TL, Goldberg JP. Sexual pharmacology: drugs that affect sexual functioning. New York, NY: WW Norton & Company, 1996.
Ramasubbu R. Switching to moclobemide to reverse fluoxetine-induced sexual dysfunction in patients with depression. J Psychiatry Neurosci 1999; 24(1): 45-50.
Kennedy SH, Eisfeld BS, Dickens SE, Bacchiochi JR, Bagby RM. Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry 2000; 61(4): 276-281.
Philipp M, Tiller JW, Baier D, Kohnen R. Comparison of moclobemide with selective serotonin reuptake inhibitors (SSRIs) on sexual function in depressed adults. The Australian and German study groups. Eur Neuropsychopharmacol 2000; 10(5): 305-314.
Kennedy SH, Ralevski E, Davis C, Neitzert C. The effects of moclobemide on sexual desire and function in healthy volunteers. Eur Neuropsychopharmacol 1996; 6(3): 177-181.
Corona G, Ricca V, Bandini E, Mannucci E et al. Selective serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Med 2009; 6(5): 1259-1269.
Modell JG, Katholi CR, Modell JD, DePalma RL. Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther 1997; 61(4): 476-487.
Waldinger MD, Hengeveld MW, Zwinderman AH, Olivier B. Effect of SSRI antidepressants on ejaculation: a double-blind, randomized, placebo-controlled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. J Clin Psychopharmacol 1998; 18(4): 274-281.
Waldinger MD, Zwinderman AH, Olivier B. SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram. J Clin Psychopharmacol 2001; 21(6): 556-560.
Lee KU, Lee YM, Nam JM, Lee HK, Kweon YS et al. Antidepressant-Induced sexual dysfunction among newer antidepressants in a naturalistic setting. Psychiatry Investig 2010; 7(1): 55-59.
Ashton AK. Reversal of fluoxetine-induced sexual dysfunction by switching to escitalopram. J Sex Marital Ther 2004; 30(1): 1-2.
Berk M, Acton M. Citalopram-associated clitoral priapism: a case series. Int Clin Psychopharmacol 1997; 12: 121-122.
Virit O, Savas HA. Citalopram-associated spontaneous ejaculations. J Clin Psychopharmacol 2008; 28(3): 360-361.
Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol 2009; 29(3): 259-266.
Montgomery SA, Baldwin DS, Riley A. Antidepressant medications: a review of the evidence for drug-induced sexual dysfunction. J Affect Disord 2002; 69: 119-140.
Delgado PL, Brannan SK, Mallinckrodt CH, Tran PV, McNamara RK, Wang F, Watkin JG, Detke MJ. Sexual functioning assessed in 4 double-blind placebo- and paroxetine-controlled trials of duloxetine for major depressive disorder. J Clin Psychiatry 2005; 66(6): 686-692.
Clayton A, Kornstein S, Prakash A, Mallinckrodt C, Wohlreich M. Changes in sexual functioning associated with duloxetine, escitalopram, and placebo in the treatment of patients with major depressive disorder. J Sex Med 2007; 4(4 Pt 1): 917-929.
Montejo AL, Perahia DG, Spann ME et al. Sexual function during long-term duloxetine treatment in patients with recurrent major depressive disorder. J Sex Med 2011; 8(3): 773-782.
Owen AM. Venlafaxine-induced increased libido and spontaneous erections. Br J Psychiatry 1986; 170: 193.
Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol 2009; 29(2): 157-164.
Baldwin D, Moreno RA, Briley M. Resolution of sexual dysfunction during acute treatment of major depression with milnacipran. Hum Psychopharmacol 2008; 23(6): 527-532.
Takahashi H, Ishigooka J. Improvement of selective serotonin reuptake inhibitor-induced sexual dysfunction without worsening of depressive symptom after switching to milnacipran. Clin Neuropharmacol 2009; 32(3): 177-178.
Saiz-Ruiz J, Montes JM, Ibáñez A, Díaz M et al. Assessment of sexual functioning in depressed patients treated with mirtazapine: a naturalistic 6-month study. Hum Psychopharmacol 2005; 20(6): 435-440.
Gelenberg AJ, McGahuey C, Laukes C, Okayli G, Moreno F et al. Mirtazapine substitution in SSRI-induced sexual dysfunction. J Clin Psychiatry 2000; 61(5): 356-360.
Koutouvidis N, Pratikakis M, Fotiadou A. The use of mirtazapine in a group of 11 patients following poor compliance to selective serotonin reuptake inhibitor treatment due to sexual dysfunction. Int Clin Psychopharmacol 1999; 14(4): 253-255.
Ozmenler NK, Karlidere T, Bozkurt A, Yetkin S et al. Mirtazapine augmentation in depressed patients with sexual dysfunction due to selective serotonin reuptake inhibitors. Hum Psychopharmacol 2008; 23(4): 321-326.
Ravindran LN, Eisfeld BS, Kennedy SH. Combining mirtazapine and duloxetine in treatment-resistant depression improves outcomes and sexual function. J Clin Psychopharmacol 2008; 28: 107-108.
Coleman CC, King BR, Bolden-Watson C et al. A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clin Ther 2001; 23(7): 1040-1058.
Kennedy SH, Fulton KA, Bagby RM, Greene AL et al. Sexual function during bupropion or paroxetine treatment of major depressive disorder. Can J Psychiatry 2006; 51(4): 234-242.
Segraves RT, Croft H, Kavoussi R, Ascher JA et al. Bupropion sustained release (SR) for the treatment of hypoactive sexual desire disorder (HSDD) in non-depressed women. J Sex Marital Ther 2001; 27(3): 303-316.
Safarinejad MR. The effects of the adjunctive bupropion on male sexual dysfunction induced by a selective serotonin reuptake inhibitor: a double-blind placebo-controlled and randomized study. BJU Int 2010; 106(6): 840-847.
Thase ME, Haight BR, Richard N et al. Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. J Clin Psychiatry 2005; 66: 974-981.
DeVeaugh-Geiss J, Landau P, Katz R. Preliminary results from a multi-ƒcenter trial of clomipramine in obsessive-compulsive disorder. Psychopharm Bull 1989; 25: 36-40.
Monteiro WO, Norsirvani HF, Marks IM, Lelliott PT. Anorgasmia from clomipramine in obsessive-compulsive disorder: as controlled trial. Br J Psychiatry 1987; 151: 107-112.
Haensel SM, Rowland DL, Kallan KT. Clomipramine and sexual function in men with premature ejaculation and controls. J Urol 1996; 156(4): 1310-1315.
Karp JF, Frank E, Ritenour A, McEachran A, Kupfer DJ. Imipramine and sexual dysfunction during the long-term treatment of recurrent depression. Neuropsychopharmacology 1994; 11(1): 21-27.
Gartrell N. Increased libido in women receiving trazodone. Am J Psychiatry 1986; 143: 781-782.
Pescatori, ES, Engelman, JC, Davis, G, Goldstein I. Priapism of the clitoris: a case report following trazodone use. J Urology 1993; 149: 1559.
Stryjer R, Spivak B, Strous RD, Shiloh R et al. Trazodone for the treatment of sexual dysfunction induced by serotonin reuptake inhibitors: a preliminary open-label study. Clin Neuropharmacol 2009; 32(2): 82-84.
Demyttenaere K, Huygens R. Painful ejaculation and urinary hesitancy in association with antidepressant therapy: relief with tamsulosin. Eur Neuropsychopharmacol 2002; 12(4): 337.
Sivrioglu EY, Topaloglu VC, Sarandol A, Akkaya C, Eker SS, Kirli S. Reboxetine induced erectile dysfunction and spontaneous ejaculation during defecation and micturition. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31(2): 548-550.
Baldwin D, Bridgman K, Buis C. Resolution of sexual dysfunction during double-blind treatment of major depression with reboxetine or paroxetine. J Psychopharmacol 2006; 20(1): 91-96.
Clayton AH, Zajecka J, Ferguson JM, Filipiak-Reisner JK, Brown MT, Schwartz GE. Lack of sexual dysfunction with the selective noradrenaline reuptake inhibitor reboxetine during treatment for major depressive disorder. Int Clin Psychopharmacol 2003; 18(3): 151-156.
Montejo AL, Prieto N, Terleira A, Matias J et al. Better sexual acceptability of agomelatine (25 and 50 mg) compared with paroxetine (20 mg) in healthy male volunteers. An 8-week, placebo-controlled study using the PRSEXDQ-SALSEX scale. J Psychopharmacol 2010; 24(1): 111-120.
Kennedy SH, Rizvi S, Fulton K, Rasmussen J. A double-blind comparison of sexual functioning, antidepressant efficacy, and tolerability between agomelatine and venlafaxine XR. J Clin Psychopharmacol 2008; 28(3): 329-333.
McGahuey, CA, Gelenberg, AJ, Laukes, CA, Manber R et al. The Arizona sexual experiences scale: validity and reliability. Presented at the New Research, American Psychiatric Association 150th Annual Meeting, San Diego, May 17–22, 1997.
Balon R. SSRI-associated sexual dysfunction. Am J Psychiatry 2006; 163: 9.
Boyarsky BK, Hirschfeld RM. The management of medication-induced sexual dysfunction. Essent Psychofarmacol 2000; 3: 2.
Rothschild AJ. Selective serotonin reputake inhibitor-induced sexual dysfunction: Efficacy of a drug holiday. Am J Psychiatry 1991; 152: 1514-1516.
Nemeth A, Arato M, Treuer T, Vandlik E. Treatment of fluvoxamine-induced anorgasmia with a partial drug holiday. Am J Psychiatry 1996; 153: 1365.
Balough S, Hendricks S, Kang J. Treatment of fluoxetine-induced anorgasmia with amantadine. J Clin Psychiatry 1992; 53: 212-213.
Taylor MJ, Rudkin L, Hawton K. Strategies for managing antidepressant-induced sexual dysfunction: systematic review of randomized controlled trials. J Affect Disord 2005; 88(3): 241-254.
Bodkin JA, Lasser MD, Wines JD, Gardner DM, Baldessarini RJ. Combining serotonin reuptake inhibitors and bupropion in partial responders to antidepressant monotherapy. J Clin Psychiatry 1997; 58: 137-145.
Aston AK, Rosen RC. Bupropion as an antidote for serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry 1998; 59: 112-115.
Balon R, Segraves RT. Survey of treatment practices for sexual dysfunction(s) associated with anti-depressants. J Sex Marital Ther 2008; 34: 353-365.
Aizenberg D, Zemishlany Z, Weizman A. Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibition. Clin Neuropharmacol 1995; 18(4): 320-324.
Arnott S, Nutt S. Successful treatment of fluvoxamine-induced anorgasmia by cyproheptadine. Br J Psychiatry 1994; 164: 838-839.
Katz R, Rosenthal M. Adverse interaction of cyproheptadine with serotonergic antidepressants. J Clin Psychiatry 1994; 55: 314-315.
Hollander E, McCarley A. Yohimbine treatment of sexual side effects induced by serotonin reuptake blockers. J Clin Psychiatry 1992; 53: 207-209.
Michelson D, Kociban K, Tamura R, Morrison MF. Mirtazapine, yohimbine or olanzapine augmentation therapy for serotonin reuptake-associated female sexual dysfunction: a randomized, placebo controlled trial. J Psychiatr Res 2000; 36: 147-152.
Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998; 24(2): 139-143.
Oulis P, Kouzoupis AV, Koulouris G, Masdrakis VG, Kontoangelos K, Matsoukas T, Papadimitriou GN. Acute pregabalin reversal of citalopram-induced sexual dysfunction in generalized anxiety disorder. J Clin Psychopharmacol 2008; 28(3): 362-363.