Antidepressant-Induced Sexual Dysfunction

Abstract

Sexual dysfunction is a common adverse effect of antidepressant treatment. Physicians should monitor their patients for antidepressant-induced sexual adverse effects, as these may affect compliance with therapy and ultimate treatment success. In addition to the consequences for patient health and well-being, managed-care organizations should be concerned with sexually related adverse effects of antidepressants, insofar as additional healthcare resources may be required to treat depressed patients in whom these adverse effects arise.

Examining SLV-323, a novel NK1 receptor antagonist, in a chronic psychosocial stress model for depression

“…This finding clearly supports recent theories suggesting that tachykinins may have a physiological modulatory role on testicular function (Debeljuk et al 2003). The observation that SLV-323 substantially stimulated testosterone production above the normal level suggests that SLV-323 treatment may avoid the common and unwanted side effect of many antidepressant drugs: sexual dysfunction (Gregorian et al 2002). However, high testosterone concentration may lead to other side effects (e.g., aggression).…”

A novel approach for predicting antidepressant-induced sexual dysfunction in rats

“…Fluoxetine was chosen based on multiple studies establishing that SSRIs and, more specifically, fluoxetine produced marked levels of sexual dysfunction clinically (Baldwin 2001;Gregorian et al 2002;Modell et al 1997;Worthington and Peters 2003). Desipramine was chosen to represent the tricyclic antidepressants that show fewer sexual side effects than SSRIs (Harrison et al 1986).…”

“…Desipramine was chosen to represent the tricyclic antidepressants that show fewer sexual side effects than SSRIs (Harrison et al 1986). Bupropion, the D/NRI, was chosen based on reports that it produces much lower rates (<10%) of sexual dysfunction (Baldwin 2001;Gregorian et al 2002;Worthington and Peters 2003). Comparisons of the doses that produce deficits in this model after chronic administration with those that predict antidepressant-like effects is critical for any model of antidepressant-induced sexual dysfunction to determine the therapeutic window.…”

“…One of the first studies evaluating the effects of antidepressants on sexual function revealed that 30% of patients treated with the tricyclic antidepressant imipramine reported impairment in sexual function (Harrison et al 1986). Depending on the study design and how sexual dysfunction was assessed, fluoxetine-induced sexual dysfunction varies from 8 to 75% (Baldwin 2001), with selective serotonin reuptake inhibitors (SSRIs) generally producing an incidence range of 30 to 60% (Gregorian et al 2002;Modell et al 1997;Worthington and Peters 2003). Conversely, the dopamine and norepinephrine reuptake inhibitor (D/NRI) bupropion and the 5-HT 2A antagonist and weak serotonin uptake inhibitor nefazodone are reported to have much lower rates (<10%) of sexual dysfunction (Baldwin 2001;Gregorian et al 2002;Worthington and Peters 2003).…”

Acid sensing ion channel (ASIC) inhibitors exhibit anxiolytic-like activity in preclinical pharmacological models

“…Furthermore, sudden cessation from benzodiazepines following repeated administration can result in deleterious withdrawal symptoms such as tremors, sleep disturbances, and exacerbation of anxiety symptoms (Khong et al 2004). Additionally, SSRIs such as Paxil® (paroxetine), while sometimes effective in treating anxiety, require chronic administration and produce side effects, such as sexual dysfunction (Gregorian et al 2002;Rothschild 2000) and nausea or vomiting (Greist et al 2004). Due to these limitations, there is a clear unmet medical need to develop a new generation of effective and better-tolerated anxiolytic agents.…”