SSRIs and sexual dysfunction in patients with major depression

Purpose: This study investigates sexual dysfunction caused by SSRIs in patients with major depression .

Method: 100 patients (53 w-47 m) with major depression were studied; we administered equally strong doses of SSRIs (fluvoxamine 75 mg, fluoxetine 20 mg, paroxetine 20 mg, citalopram 20 mg, sertraline 75 mg) and alprazolam <1 mg/day, in 80% of patients for 4 weeks. The patients did not report any sexual dysfunction before the start of the therapy. Patients with a concurrent pathology and use of drugs that cause themselves sexual disfunction were excluded. We used the Arizona sexual experience scale (ASEX) and HAM-D17. The patients were evaluated before the start of the treatment, on the 6th and 12th week.A statistical analysis was done using chi-square.

Results: Mean age was 42y. 55% of the patients were having their first episode of major depression. 55% of patients reported some form of sexual disfunction by week 6. Specifically 50% of patients taking fluoxetine, 65% with paroxetine, 55% with citalopram, 50% with certraline and with fluvoxamine 55%. There was no statistically significant difference between them. On the 12th week 14% of the patients who developed sexual disfunction had significant or moderate improvement of sexual dysfunction. 1/3 of patients considered sexual dysfunction a serious side effect.

Conclusions: Sexual dysfunction is underestimated by psychiatrists even though it is the most serious side effect of SSRIs. Sexual dysfunction presence and intensity is maintained for the duration of the treatment.

Key words: SSRIs, sexual dysfunction, major depression.