Prevalence of sexual dysfunction among newer antidepressants.
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.
Clayton
Anita H
AH
Department of Psychiatric Medicine, University of Virginia, Charlottesville 22903, USA. ahc8v@virginia.edu
Pradko
James F
JF
Croft
Harry A
HA
Montano
C Brendan
CB
Leadbetter
Robert A
RA
Bolden-Watson
Carolyn
C
Bass
Kristin I
KI
Donahue
Rafe M J
RM
Jamerson
Brenda D
BD
Metz
Alan
A
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
D000928:Antidepressive Agents; D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride