Symptoms of sexual dysfunction in patients treated for major depressive disorder: a meta-analysis comparing selegiline transdermal system and placebo using a patient-rated scale.
OBJECTIVE
Spontaneous reports of sexual side effects were infrequent during placebo-controlled clinical trials of selegiline transdermal system (STS). The objective of this study was to examine the impact of STS 6 mg/24 hours on various domains of sexual function in patients with major depressive disorder (MDD), using a patient-rated questionnaire.


METHODS
Data from 4 short-term (6 to 8 weeks), randomized, double-blind, placebo-controlled trials of STS in patients with MDD (DSM-IV criteria) were included in the meta-analysis (STS, N = 389; placebo, N = 400). The Medex Sexual Dysfunction Subscale was used to assess sexual interest, arousal, maintenance of interest, orgasm, and satisfaction. Estimates of the average effect of study drug on each item of sexual function and 95% confidence intervals were calculated using a fixed-effects model due to homogeneity of study means. The direct effect of STS versus placebo was estimated using multivariate regression models, with baseline item score as a covariate and controlling for improvement in depression. Analyses were performed on the total population and by gender. Data were collected between January 1997 and April 2000.


RESULTS
Estimates of difference between STS and placebo demonstrated a nonsignificant trend toward a positive treatment effect of STS on most sexual function items and significant improvement in sexual satisfaction. For women, there was a significant positive effect on interest, maintaining interest during sex, and satisfaction. The direct effect of STS on changes in individual item scores was minimal in men and showed a trend for improvement in women.


CONCLUSIONS
This meta-analysis suggests that short-term therapy with STS 6 mg/24 hours does not impair any aspect of sexual function in MDD patients as measured using a patient-rated questionnaire.
Clayton
Anita H
AH
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville,VA 22908, USA.
Campbell
Bryan J
BJ
Favit
Antonella
A
Yang
Ying
Y
Moonsammy
George
G
Piontek
Catherine M
CM
Amsterdam
Jay D
JD
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012642:Selegiline / Q000008:administration & dosage / Q000009:adverse effects*; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*
D008996:Monoamine Oxidase Inhibitors; D010919:Placebos; D012642:Selegiline