title: Prevalence of sexual dysfunction among newer antidepressants.
abstract: BACKGROUND
  Sexual dysfunction commonly occurs during antidepressant treatment. However, the reported rates of sexual dysfunction vary across antidepressants and are typically underreported in product literature. The objectives of this study were (1) to estimate the prevalence of sexual dysfunction among patients taking newer antidepressants (bupropion immediate release [IR], bupropion sustained release [SR], citalopram, fluoxetine, mirtazapine, nefazodone, paroxetine, sertraline, venlafaxine, and venlafaxine extended release [XR]) and (2) to compare physician-perceived with patient-reported prevalence rates of antidepressant-associated sexual dysfunction.
  
  
  METHODS
  This cross-sectional, observational study was conducted in 1101 U.S. primary care clinics. Adult outpatients (4534 women and 1763 men) receiving antidepressant monotherapy were enrolled. The prevalence of sexual dysfunction was measured using the Changes in Sexual Functioning Questionnaire.
  
  
  RESULTS
  In the overall population, bupropion IR (22%) and SR (25%) and nefazodone (28%) were associated with the lowest risk for sexual dysfunction, whereas selective serotonin reuptake inhibitor (SSRI) antidepressants, mirtazapine, and venlafaxine XR were associated with higher rates (36%-43%). In a prospectively defined subpopulation unlikely to have predisposing factors for sexual dysfunction, the prevalence of sexual dysfunction ranged from 7% to 30%, with the odds of having sexual dysfunction 4 to 6 times greater with SSRIs or venlafaxine XR than with bupropion SR. Physicians consistently underestimated the prevalence of antidepressant-associated sexual dysfunction.
  
  
  CONCLUSIONS
  Ours is the first study to assess sexual dysfunction across the newer antidepressants using consistent methodology and a validated rating scale. Overall, SSRIs and venlafaxine XR were associated with higher rates of sexual dysfunction than bupropion or nefazodone. Because antidepressant-associated sexual dysfunction is considerably underestimated by physicians, greater recognition and education are imperative when prescribing antidepressant treatment.
authors: Department of Psychiatric Medicine, University of Virginia, Charlottesville 22903, USA. ahc8v@virginia.edu
authors: Anita H
authors: AH
authors: Clayton
authors: James F
authors: JF
authors: Pradko
authors: Harry A
authors: HA
authors: Croft
authors: C Brendan
authors: CB
authors: Montano
authors: Robert A
authors: RA
authors: Leadbetter
authors: Carolyn
authors: C
authors: Bolden-Watson
authors: Kristin I
authors: KI
authors: Bass
authors: Rafe M J
authors: RM
authors: Donahue
authors: Brenda D
authors: BD
authors: Jamerson
authors: Alan
authors: A
authors: Metz
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010821:Physicians, Family / Q000523:psychology; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced* / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D000069470:Venlafaxine Hydrochloride
chemical_list: D000928:Antidepressive Agents; D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride