title: Treatment-emergent sexual dysfunction with SSRIs and duloxetine: effectiveness and functional outcomes over a 6-month observational period.
abstract: OBJECTIVE
  To evaluate frequencies of treatment-emergent sexual dysfunction (TESD) in patients with major depressive disorder (MDD) treated with duloxetine or selective serotonin reuptake inhibitor (SSRI) monotherapy for up to 6 months in a prospective, observational study.
  
  
  METHODS
  Sexually active MDD patients without sexual dysfunction at entry were enrolled from twelve countries (N = 1,647). TESD was assessed over the study period using the Arizona sexual experience (ASEX) scale. A priori-specified secondary 6-month clinical endpoints were also examined.
  
  
  RESULTS
  The frequency of TESD at 6 months with duloxetine was comparable to that with SSRI monotherapy (23.4 and 28.7%, respectively; P = 0.087). Improvements in Clinical Global Impressions of Severity (CGI-S), 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR(16)), Integral Inventory for Depression (IID) total scores, remission and sustained remission rates were statistically significantly greater with duloxetine than SSRI monotherapy at 6 months (P < 0.001 for each), but TESD attenuated improvements in quality of life measures. Four factors were consistently significantly (P ≤ 0.05) associated with TESD at week 8 and 6 months.
  
  
  CONCLUSIONS
  Six-month TESD rates were comparable between duloxetine and SSRIs, with greater MDD effectiveness in favour of duloxetine. Improved recognition and management of TESD may improve quality of life for MDD patients in usual clinical practice.
authors: ICR Medical, Eli Lilly de México, Col. San José Insurgentes, Mexico City, Mexico. duenas_hector@lilly.com
authors: Héctor
authors: H
authors: Dueñas
authors: Alan J M
authors: AJ
authors: Brnabic
authors: Arier
authors: A
authors: Lee
authors: Angel L
authors: AL
authors: Montejo
authors: Siva
authors: S
authors: Prakash
authors: Ma Luz S
authors: ML
authors: Casimiro-Querubin
authors: Mohamed
authors: M
authors: Khaled
authors: Martin
authors: M
authors: Dossenbach
authors: Joel
authors: J
authors: Raskin
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology; D000328:Adult; D003865:Major Depressive Disorder / Q000188:drug therapy*; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*; D013876:Thiophenes / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes