The ELIXIR study: evaluation of sexual dysfunction in 4557 depressed patients in France.
OBJECTIVE
This survey was conducted in order to determine the extent and nature of disorders of sexual function in depressed patients treated in the community in France.


METHODS
Patients with DSM-IV major depressive episodes were included. The inclusion criteria stipulated that only patients with no antecedents of sexual dysfunction could be included. Information on sexual function was collected with a questionnaire which included physician observations as well as the Arizona Sexual Experience Scale.


RESULTS
Overall, 4557 patients were included in the study. The prevalence of disorders of sexual function observed was 35% for spontaneously reported problems and 69% for problems identified by physician questioning. Impaired sexual function in depressed patients is also revealed by a high score on the Arizona Sexual Experience Scale (mean overall score of 21.4). Frequency of sexual dysfunction was somewhat higher in patients treated with antidepressants than in untreated patients (71% and 65% respectively). Treatment with tianeptine was associated with a lower incidence of sexual dysfunction than was treatment with tricyclic antidepressants or with selective serotonin reuptake inhibitors. Although in 39% of cases, physicians managed the sexual problems encountered by changing the antidepressant treatment, the most frequently adopted approach (42% of cases) was to await spontaneous remission. Drug holidays or adjunctive therapy were very rarely proposed.


CONCLUSIONS
The prevalence of sexual dysfunction in patients with major depression is high. Antidepressant drugs appear to aggravate such problems, with certain classes of drug better tolerated than others. Sexual dysfunction in depressed patients is often not optimally treated.
Psychiatry Department, CHU Sainte Marguerite, 270, boulevard de Sainte Marguerite, 13274 MARSEILLE Cedex 9, France. mireille.bonierbale@wanadoo.fr
Mireille
M
Bonierbale
Christophe
C
Lançon
Jean
J
Tignol
D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced* / Q000453:epidemiology*
D000928:Antidepressive Agents