Although the positive effects of SSRIs, clomipramine, and monoamine oxidase inhibitors are now well documented, there is a cost in terms of side effects. In males, inability to maintain an erection or even complete impotence may occur. If the clinician does not specifically ask about sexual difficulties, it may appear that they are quite rare since patients are often embarrassed or more commonly, they do not think to blame medication for these problems and may attribute them to difficulties in their relationships. It is not completely clear what the mechanism of these sexual difficulties is, but most of the evidence for anorgasmia supports the hypothesis that increased serotonergic activity is inhibitory to ejaculation and orgasm.
This article has been cited by other articles in PMC. Abstract Objective 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.
Methods Participants were married patients diagnosed with depression, per DSM-IV diagnostic criteria, who had been taking antidepressants for more than 1 month. Results One hundred and one patients 46 male, 55 female, age Thirteen were taking fluoxetine mean dose A substantial number of participants The prevalence of sexual dysfunction differed across drugs: Of the antidepressants, the mirtarzapine group's total ASEX score was significantly lower than the scores of the citalopram, fluoxetine, and paroxetine groups.
Conclusion 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.
Depression, Sexual dysfunction, Antidepressants Introduction With regard to side effects, numerous clinical needs remain persistently unmet, despite the advances of psychopharmacology.
Antidepressant therapy, although effective for treating the symptoms of depression, frequently induces or exacerbates the relatively common side effect of sexual dysfunction, 1 - 5 which occurs in approximately one-half of patients.
During antidepressant treatment, typical sexual dysfunction symptoms include diminished or absent libido, arousal difficulties, erectile dysfunction in menvaginal lubrication difficulties in womendelayed orgasm, and anorgasmia.
These sexual side effects may affect the patient's quality of life and can lead to non-compliance and relapse in long-term treatment. The incidence of sexual dysfunction seems to differ among these antidepressants as a result of their differences in mechanism of action. Although the SSRIs have a more favorable side-effect profile than do the tricyclic antidepressants, sexual dysfunction remains a significant problem with their use.
Reportedly, the rates of sexual dysfunction with venlafaxine are lower or similar to those of SSRIs. Because it blocks the type 2 and 3 serotonin receptors, this drug theoretically produces less sexual side effects than do SSRIs.
Although many studies of antidepressant-induced sexual dysfunction have been conducted in western societies, there is little information on the incidence of such in Korea.
Though Chae et al. The Arizona Sexual Experiences Scale ASEX 11 is a gender-specific, five-item self-report measure that specifically assesses sexual functioning in terms of current level of sexual drive, psychological arousal, physiologic arousal erections or vaginal lubricationease of orgasm, and orgasm satisfaction.
Thus, in the present study, we used the ASEX to investigate the prevalence of sexual dysfunction among depressed patients taking the newer antidepressants citalopram, fluoxetine, paroxetine, venlafaxine, and mirtazapine.
Methods We recruited our participants from the married outpatients of the Department of Psychiatry, Uijeongbu St. Mary's Hospital, the Catholic University of Korea. Patients were eligible if they 1 were between 18 and 50 years, 2 had a diagnosis of a depressive disorder that met DSM-IV criteria, 3 had been taking SSRI fluoxetine, paroxetine, or citalopramvenlafaxine, or mirtazapine monotherapy for more than 1 month.
We excluded patients for any one of the following reasons: As mentioned, we assessed the participants' sexual functioning using the Arizona Sexual Experiences Scale. Subjects rate their current level of sexual drive, psychologic arousal, physiological arousal erections or vaginal lubricationease of orgasm, and orgasm satisfaction on a 6-point Likert scale.
A total ASEX score of 19 or greater, any one item with an individual score of 5 or greater, or any three items with individual scores of 4 or greater are all highly correlated with the presence of clinician-diagnosed sexual dysfunction.
For this study, two psychiatrists fluent in English translated the ASEX into Korean, and two other psychiatrists translated this Korean version back into English. The translation and back-translation procedure was repeated by four psychiatrists until they agreed that back-translation was sufficiently similar to the original scale.
We divided the ASEX item scores into subscores for 1 desire, 2 arousal, including sex drive and arousal, and 3 orgasm, including ease of orgasm and orgasm satisfaction.
Then, we averaged the subscores for arousal and orgasm, each containing two items, to get a single mean score. To control for the effect of depression and anxiety on sexual functioning, we also assessed participants using the Beck Depression Inventory BDI 13 and State-Trait Anxiety Inventory STAI 1415 and assessed their demographic variables, type and dosages of antidepressants, and duration of antidepressant use via their medical records.
The study's data analysis used the t-test or chi-square statistics, depending upon the type of variable being investigated. Among the participant groups, each using a different antidepressant, we compared the ASEX total differences and subscale scores, using ranks, by means of the Kruskal-Wallis test and the least significant difference LSD.
We used multiple regression analysis to determine which variables related to sexual dysfunction, considering a probability p value of less than 0. The hospitals' institutional review boards approved this study.
Each of the participants provided informed consent for their participation in this study after receiving a full explanation of the procedure.Sexual dysfunction is also a common side effect of treatment with serotonergic antidepressants and may be a reason that patients on SSRIs and other serotonergic medications discontinue treatment .
Others, like decreased sexual desire, may last longer. Not everyone has the same side effects. And a particular antidepressant doesn’t cause the same side effects in all people.
Many things, including your genetic makeup or existing health conditions, can affect the way you respond to taking an antidepressant. Sexual dysfunction is an adverse effect of antidepressants that occurs in about 20% to 45% of treated patients, depending on the antidepressant used.
2 Dysfunction presents as alterations in one or more sexual phases, and antidepressants can affect all phases of sexual function. 3 Common dysfunctions include reduced libido, erectile or vaginal. Feb 08, · Objective. 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. Sep 09, · Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person’s quality of life, relationships, mental health, and recovery.
Treatment of Sexual Side Effects: Antidotes. A variety of antidotes have been reported to treat SSRI-induced sexual dysfunction effectively; however, virtually all the data on these agents are.