[Sexual dysfunction secondary to SSRIs. A comparative analysis in 308 patients].
The authors analyze the incidence of sexual dysfunction (SD) with different SSRIs (Fluoxetine, Fluvoxamine, Paroxetine and Sertraline) and hence the qualitative and quantitative changes in SD throughout time 308 outpatients (169 women, 139 men; mean +/- SD age = 41 +/- 7) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors including questions about the following items decreased libido, delayed orgasm or anorgasmia, delayed ejaculation inability to ejaculation, impotence and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRIs intake, exclusive treatment with SSRIs or associated with benzodiazepines, previous heterosexual or self-orone current sexual practices. We excluded patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recently hormone intake and significant medical illnesses.


RESULTS
There is a significant increase in the incidence of SD when the physicians ask the patients direct questions (55.29%) versus spontaneous SD reported (14.2%). There are some significant differences among different SSRIs paroxetine provoked more delay of orgasm/ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (Chi square p < 0.05). Only 22.6% of the patients had a good tolerance about their sexual dysfunction. SD has positive correlation with the dose. The patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women but women's sexual dysfunction was more intense than men. Seven of nine patients (77.7%) experienced total improvement when the treatment was changed to Moclobemide (450 mg/day) and two of four patients (50%) improved when treatment was changed to Amineptine.
Montejo
A I
AI
Llorca
G
G
Izquierdo
J A
JA
Ledesma
A
A
Bousoño
M
M
Calcedo
A
A
Carrasco
J L
JL
Daniel
E
E
de Dios
A
A
de la Gándara
J
J
Derecho
J
J
Franco
M
M
Gómez
M J
MJ
Macías
J A
JA
Martín
T
T
Pérez
V
V
Sánchez
J M
JM
Sánchez
S
S
Vicens
E
E
D015057:1-Naphthylamine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001549:Benzamides / Q000008:administration & dosage / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy; D003986:Dibenzocycloheptenes / Q000008:administration & dosage / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004542:Ejaculation / Q000187:drug effects; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D016666:Fluvoxamine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020912:Moclobemide; D009948:Orgasm / Q000187:drug effects; D017374:Paroxetine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D020280:Sertraline; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*
D015057:1-Naphthylamine; D000928:Antidepressive Agents; D001549:Benzamides; D003986:Dibenzocycloheptenes; D005473:Fluoxetine; D016666:Fluvoxamine; D020912:Moclobemide; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; C011597:amineptin
Disfunción sexual secundaria a ISRS. Análisis comparativo en 308 pacientes.