Prevalence and impact of antidepressant-associated sexual dysfunction in three European countries: replication in a cross-sectional patient survey

Abstract

Sexual dysfunction is a common but often unrecognized side effect of many antidepressants. Building upon the results of a previous investigation, this study aimed to assess the prevalence and impact of antidepressant-associated sexual dysfunction (AASD) in three European countries. A cross-sectional survey of 704 adults in Germany, Spain, and The Netherlands was used in the study. All participants had recently started taking a selective serotonin reuptake inhibitor or serotonin- noradrenaline reuptake inhibitor. Information about other medications and conditions known to impair sexual functioning was gathered, and changes in sexual functioning and the impact of such changes were assessed. The SF-12 and Arizona Sexual Experience Scale (ASEX) were administered to measure health status and sexual functioning. AASD was defined using ASEX scores and information regarding changes in sexual functioning. ASEX scores generally exceeded the threshold defining sexual dysfunction: 67.2% in the German, 79.4% in the Spanish, and 73.3% in the Dutch samples. The prevalence of AASD was conservatively estimated to be between 37.1% (German sample) and 61.5% (Spanish sample). Overall, 46.4% of male and 52.1% of female participants were classified with AASD. Patients classified with AASD reported significantly worse quality of life (QoL), self-esteem, mood, and relationships with partners, compared with non-AASD patients. There were significant differences between patients with and without AASD in SF-12 Mental Component scores, with AASD patients displaying poorer mental well-being. Sexual dysfunction is a frequent occurrence during antidepressant treatment, and is associated with reduced QoL and self-esteem, and negative effects on mood and relationships.

The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management

“…Two international studies of the prevalence of sexual dysfunction in depressed patients undergoing treatment with either an SSRI or serotonin-noradrenaline reuptake inhibitor (SNRI), which both accounted for self-reported sexual problems before starting treatment and the potential adverse effects of concomitant medication, found that 27-65% of female and 26-57% of male patients experienced either a worsening of pre-existing difficulties or the emergence of new sexual difficulties in the early weeks of treatment 65,66 .…”

Antidepressant-Induced Sexual Side Effects: Incidence, Assessment, Clinical Implications, and Management

“…13 SD is one of the main reasons patients choose to discontinue SSRI treatment, and it can also cause poor adherence patterns among patients who choose to continue taking the medication. 4 In one study of patients with major depressive disorder, 85% of patients rated the management of sexual dysfunction as "extremely important," "very important," or "important."…”

Antidepressant-induced sexual dysfunction

“…(See Table I.) Nonetheless, the general consensus is, firstly, that there is a high incidence of sexual dysfunction attributable to SSRI and SNRI usagethe best estimate probably in the region of 30 to 50% -and that this is a dose-related class effect, 25 secondly, consensus is that drugs with different pharmacological actions are less inclined to affect sexual functioning.…”