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Comment in:
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@globalmed.es
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.
Publication Types:
- Clinical Trial
- Multicenter Study
PMID: 11229449 [PubMed - indexed for
MEDLINE]
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