Prevalence of Sexual Dysfunction Among Newer Antidepressants

Clayton, Anita H.; Pradko, James F.; Croft, Harry A.; Montano, C. Brendan; Leadbetter, Robert A.; Bolden‐Watson, Carolyn; Bass, Kristin I; Donahue, Rafe; Jamerson, Brenda D.; Metz, Alan

doi:10.4088/jcp.v63n0414

Cited by 488 publications

(364 citation statements)

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“…The CSFQ consists of separate assessments for males and females, and has been validated in healthy and depressed clinic populations, and used in both longitudinal and cross sectional studies of sexual well-being (Clayton et al, 1995(Clayton et al, , 1997b(Clayton et al, , 2002Keller et al, 2006). Questions on the CSFQ assess a variety of Antidepressant dose characteristics (reported in mg/day) for the study population as a whole.…”

Section: Assessmentsmentioning

confidence: 99%

“…Sexual dysfunction is a common and disconcerting sideeffect of SSRIs that influences a patient's desire to continue long-term antidepressant treatment (Bull et al, 2002;Clayton et al, 2002;Montejo et al, 2001). Despite clinical study reports summarized in prescriber information sheets indicating the emergence of sexual difficulties in o15% of subjects, most investigations of this topic show that the real incidence of sexual side-effects subsequent to SSRI initiation is between 20 and 70% (Clayton et al, 2002;Montejo-Gonzalez et al, 1997;Montejo et al, 1996Montejo et al, , 2001.…”

Section: Introductionmentioning

confidence: 99%

“…Despite clinical study reports summarized in prescriber information sheets indicating the emergence of sexual difficulties in o15% of subjects, most investigations of this topic show that the real incidence of sexual side-effects subsequent to SSRI initiation is between 20 and 70% (Clayton et al, 2002;Montejo-Gonzalez et al, 1997;Montejo et al, 1996Montejo et al, , 2001. Sexual side-effects from these medications are of significant clinical importance, particularly in young, sexually active patients.…”

Section: Introductionmentioning

confidence: 99%

“…Substance use/abuse, smoking, marital status, poor health, medication use, and other disease states have all been shown to have a relationship with sexual well-being in either depressed or euthymic individuals (Clayton et al, 2002;Laumann et al, 1999). The serotonergic actions of SSRIs have been implicated in the development of sexual side-effects (Murray, 1998).…”

Section: Introductionmentioning

confidence: 99%

“…Animal research has shown that action through the 5HT2A subclass of serotonin receptors decreases the sexual arousal and ejaculation components of the sexual process (Bitran and Hull, 1987). Furthermore, antidepressants such as nefazodone that block 5HT2A receptors are not associated with the significant development of sexual side-effects (Clayton et al, 2002), and 5HT2A antagonists have been shown to reverse SSRI-associated sexual side-effects in some studies (Aizenberg et al, 1995(Aizenberg et al, , 1997.…”

Section: Introductionmentioning

confidence: 99%

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Serotonin 2A −1438 G/A and G-Protein Beta3 Subunit C825T Polymorphisms in Patients with Depression and SSRI-Associated Sexual Side-Effects

Bishop

Moline

Ellingrod

et al. 2006

Neuropsychopharmacol

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The occurrence of sexual side-effects from antidepressants is thought to be mediated through serotonin 2A (5HT2A) receptors. It is currently unknown if functional polymorphisms in the 5HT2A receptor or its G-protein second messenger complex are related to sexual dysfunction in patients taking an selective serotonin reuptake inhibitor (SSRI) for depression. The purpose of this study was to determine the relationship of the 5HT2A À1438 G/A and GNB3 C825T single nucleotide polymorphisms with overall sexual well-being and individual components of sexual health as measured by the Changes in Sexual Functioning Questionnaire (CSFQ). We evaluated 89 outpatients (18-40 years of age) at low risk for other causes of sexual dysfunction who were being treated for depression with an SSRI and did not have sexual difficulties before taking the antidepressant. Outcome measures were stratified by 5HT2A and GNB3 genotypes. After controlling for age, gender, anxiety scale scores, and depression scale scores, persons with a GG genotype of the 5HT2A À1438 single nucleotide polymorphisms (SNP) were significantly more likely to be categorized as having sexual dysfunction than persons with a GA or AA genotype (OR ¼ 3.6; 95% CI 1.03, 12.6; p ¼ 0.046). Furthermore, the 5HT2A À1438 GG genotype was a significant predictor of lower arousal scores (p ¼ 0.022) after accounting for other measures. There was no significant relationship between any outcome measure and GNB3 genotype.

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Section: Assessmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serotonin 2A −1438 G/A and G-Protein Beta3 Subunit C825T Polymorphisms in Patients with Depression and SSRI-Associated Sexual Side-Effects

Bishop

Moline

Ellingrod

et al. 2006

Neuropsychopharmacol

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Treatment of Antidepressant-Associated Sexual Dysfunction With Sildenafil

Nurnberg¹,

Hensley²,

Gelenberg³

et al. 2003

JAMA

200

127

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Context Sexual dysfunction is a common adverse effect of antidepressants that frequently results in treatment noncompliance.Objective To assess the efficacy of sildenafil citrate in men with sexual dysfunction associated with the use of selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants.Design, Setting, and Patients Prospective, parallel-group, randomized, doubleblind, placebo-controlled trial conducted between November 1, 2000, and January 1, 2001, at 3 US university medical centers among 90 male outpatients (mean [SD] age, 45 [8] years) with major depression in remission and sexual dysfunction associated with SRI antidepressant treatment.Intervention Patients were randomly assigned to take sildenafil (n=45) or placebo (n = 45) at a flexible dose starting at 50 mg and adjustable to 100 mg before sexual activity for 6 weeks. Main Outcome MeasuresThe primary outcome measure was score on the Clinical Global Impression-Sexual Function (CGI-SF); secondary measures were scores on the International Index of Erectile Function, Arizona Sexual Experience Scale, Massachusetts General Hospital-Sexual Functioning Questionnaire, and Hamilton Rating Scale for Depression (HAM-D).Results Among the 90 randomized patients, 93% (83/89) of patients treated per protocol took at least 1 dose of study drug and 85% (76/89) completed week 6 endpoint assessments with last observation carried forward analyses. At a CGI-SF score of 2 or lower, 54.5% (24/44) of sildenafil compared with 4.4% (2/45) of placebo patients were much or very much improved (PϽ.001). Erectile function, arousal, ejaculation, orgasm, and overall satisfaction domain measures improved significantly in sildenafil compared with placebo patients. Mean depression scores remained consistent with remission (HAM-D score Յ10) in both groups for the study duration. ConclusionIn our study, sildenafil effectively improved erectile function and other aspects of sexual function in men with sexual dysfunction associated with the use of SRI antidepressants. These improvements may allow patients to maintain adherence with effective antidepressant treatment.

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