Sexual dysfunctions among subjects with depression on selective serotonin re-uptake inhibitors

Abstract

Background: Recent studies on the pharmacological treatment of depression suggest that selective serotonin reuptake inhibitors (SSRIs) contribute significantly to treatment-emergent sexual dysfunctions which often compromise treatment adherence and impair quality of life. Unfortunately, knowledge on this issue is scanty in resource-restricted settings.
Objectives: Longitudinal assessment of the prevalence of sexual dysfunctions among individuals with depression on SSRIs.
Methods: Participants were newly diagnosed subjects with depression per International Classification of Diseases tenth-edition (ICD-10) diagnostic criteria, and were not on treatment with antidepressants prior to diagnosis. They were assessed via a designed questionnaire to gather demographic and clinical data. Subsequently, Arizona Sexual Experience Index (ASEX) and Beck Depression Inventory (BDI) were used to explore for sexual dysfunctions and depressive symptomatology respectively.
Results: Two hundred and sixty-five subjects made up 101 males with mean age of 39.7(±9.6) years completed the instruments. Sixty subjects were taking fluoxetine (mean dose 21.3±8.5 mg/day), 109 were taking paroxetine (mean dose 20.4±7.2 mg/day) and 96 were taking escitalopram (mean dose 22.1±6.5 mg/day). The prevalence of sexual dysfunctions was 26.0% at baseline, 39.2% at 8 weeks and 49.8% at endpoint (12 weeks). There was significant difference in the mean scores of participants on ASEX and BDI across the three points of assessments. Specifically, both prevalence of sexual dysfunctions and improved depressive symptomatology (p<0.05) trended positively with increased duration of the use of SSRIs. Again, significant difference in prevalence of sexual dysfunctions (X2= 6.02, df=2, p<0.05) was seen across the various types of SSRIs: paroxetine 58.7% (n=64), fluoxetine 41.7% (n=25), and escitalopram 44.8% (n=43)
Conclusion: Findings from this study underscore the need for clinicians to consider the impacts of pharmacotherapy of depression on patients' sexual functioning in the course of using SSRIs.

Key words: Depression; Pharmacotherapy; Sexual dysfunctions; Selective Serotonin Re-uptake Inhibitors,