138: Physician Perceptions of BPH-Related Sexual Dysfunction and Drug-Related Sexual Side Effects

This chapter addresses issues surrounding sexual dysfunction after concussion. Ask the patient specifically about sexual dysfunction in private, and if appropriate ask the collateral source separately. Assess for depression, severe fatigue or hypersomnia, untreated pain, and alcohol or drug abuse (especially marijuana). Check medications for sexual side effects; serotonin specific reuptake inhibitors are the most common culprits. Test for hormonal imbalances and unrecognized cauda equina or lower spinal cord injury. Consider a trial of a PDE5 inhibitor and refer to urology for more advanced options.

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Secondary sexual dysfunction with antidepressant treatment: Study on 50 patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2202 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S591-S591

Author(s):

O.W. Muquebil Ali Al Shaban Rodriguez ◽

S. Ocio León ◽

M. Gómez Simón ◽

M.J. Hernández González ◽

E. Álvarez de Morales Gómez-Moreno ◽

...

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

Treatment Adherence ◽

Antidepressant Treatment ◽

Antidepressant Drugs ◽

Sexual Side Effects ◽

Competing Interest ◽

The Relationship ◽

Transversal Study

IntroductionThe side effects of the various antidepressant drugs on the sexual field (with very few exceptions) are well known, and they affect the quality of life in important manners. The incidence rate, communicated spontaneously by the patient, has been estimated around 10–15%, and can reach amounts of 50–60% with SSRIs when studied specifically. It has been suggested that these effects compromise treatment adherence.ObjectivesTo estimate the incidence and intensity of the side effects on the sexual field with different antidepressants, as well as its relationship with treatment adherence.MethodologyTransversal study on 50 patients assisted in medical consultation. Collection of data in office (October 2014–October 2015).Administration of survey PRSexDQ-SALSEX. In order to research the relationship with treatment adherence, one question surveyed the patient whether he/she had thought about finishing treatment for this reason.ResultsTwenty-nine patients (58% of the sample) presented some degree of sexual dysfunction. Five individuals (17.2%) communicated it spontaneously. Nine individuals (31%) responded that they did not accept positively the changes in their sexual field, and they had thought about withdrawing treatment for this reason. They were given the test of self-compliance statement (Haynes-Sackett), with a result of four non-compliant (44.4%). The most frequently involved drugs were fluoxetine (n = 5, 10% of the sample total) and paroxetine (n = 4, 8%).ConclusionsThe high impact of sexual side effects with a low rate of spontaneous communication coincides with previous existent studies.Limitation when estimating adhesion due to methodological difficulties in the design of the study. However, high impression by using the selected method of determination.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Increased libido as a buproion-SR side effect: Clinical description of a case

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2013 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S545-S545 ◽

Cited By ~ 2

Author(s):

L. Gallardo Borge ◽

C. Noval Canga ◽

L. Rodíguez Andrés ◽

I. Sevillano Benito ◽

M. Hernández García ◽

...

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

Side Effect ◽

Muscle Tension ◽

Negative Influence ◽

Sexual Life ◽

Clinical Report ◽

Consultation Room ◽

Sexual Side Effects ◽

History Of

IntroductionBupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.Clinical reportA 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.ConclusionsThe case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sexual Dysfunction

Concussion Care Manual ◽

10.1093/med/9780190054793.003.0024 ◽

2019 ◽

pp. 143-145

Author(s):

David L. Brody

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Side Effects ◽

Sexual Dysfunction ◽

Pde5 Inhibitor ◽

Cauda Equina ◽

Sexual Side Effects ◽

Severe Fatigue ◽

Cord Injury ◽

Phosphodiesterase Type

In private, ask specifically about sexual dysfunction, and if appropriate, ask the collateral source separately. Assess for depression, severe fatigue or hypersomnia, untreated pain, and alcohol or drug abuse (especially marijuana). Check medications for sexual side effects; serotonin specific reuptake inhibitors are the most common culprits. Test for hormonal imbalances and unrecognized cauda equina or lower spinal cord injury. Consider a trial of a phosphodiesterase type 5 (PDE5) inhibitor, and refer to urology for more advanced options.

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Antidepressants-Induced Sexual Troubles

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.135 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S283-S284

Author(s):

H. Ben Ammar ◽

G. Hamdi ◽

H. Zalila ◽

Z. El Hechmi

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

The Elderly ◽

Cross Sectional Study ◽

Scientific Data ◽

Sexual Disorders ◽

Cross Sectional ◽

Sexual Side Effects ◽

Major Depressive Episodes ◽

Depressive Episodes

IntroductionFor a long time, antidepressants sexual side effects have been neglected. Currently, no reliable scientific data is available regarding the nature and frequency of sexual dysfunction induced by antidepressants. The aim of our study was to evaluate the prevalence and type of sexual dysfunction induced by antidepressants, and to identify factors associated with the occurrence of these disorders.MethodologyA descriptive and analytical cross-sectional study extending over a period of two week. For the purpose of this research, a socio-demographic card, the Arizona Sexual Experiences Scale (ASEX) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX) were used.ResultsFifty-five patients were recruited. The diagnosis of major depressive episodes was dominant (49.1%). Moreover, fluoxetine and tricyclic were in top of the list of antidepressants with respective proportions of 41.8% and 38.2% and respective dose 20.86 mg/24 h and 72.38 mg/24 h. The score using the ASEX scale was 14.63 ± 5.23. Using the SALSEX scale, 47.3% of patients claimed to have had sexual disorders secondary to antidepressants with a moderate score of 9.19 ± 2.56. Furthermore, sexual disorders were more common in the elderly aged of 45 (66.66%) as well as in patients started on paroxetine (66.66%) and on sertraline (66.66%) (P ≤ 0.05).ConclusionThe sexual side effects of antidepressants have a major impact on the quality of life and adherence to treatment. They also represent an important risk factor for relapse and recurrence in major depression, in this context, the prescription of an antidepressant.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Female Sexual Side Effects Associated with Selective Serotonin Reuptake Inhibitors: A Descriptive Clinical Study of 33 Patients

The International Journal of Psychiatry in Medicine ◽

10.2190/n6c0-dwx2-g4ea-7688 ◽

1995 ◽

Vol 25 (3) ◽

pp. 239-248 ◽

Cited By ~ 47

Author(s):

Winston W. Shen ◽

Jeffrey H. Hsu

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

Adverse Effects ◽

Serotonin Reuptake ◽

Female Sexual Dysfunction ◽

Selective Serotonin Reuptake Inhibitors ◽

Spontaneous Remission ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Sexual Side Effects

Objective: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects. Methods: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects. Results: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described. Conclusions: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.

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Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review

Mental Health Clinician ◽

10.9740/mhc.2016.07.191 ◽

2016 ◽

Vol 6 (4) ◽

pp. 191-196 ◽

Cited By ~ 6

Author(s):

Elizabeth Jing ◽

Kristyn Straw-Wilson

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

Health Care Providers ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Treatment Strategies ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin ◽

Care Providers ◽

Sexual Side Effects

Abstract Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors (SSRIs) and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care providers should educate patients about SSRI-associated sexual dysfunction in order to promote patient awareness and medication adherence. This study evaluated primary literature from 1997 to 2015 to identify SSRI-related sexual side effects, therapeutic alternatives, and treatment strategies. The results indicate that paroxetine is associated with the greatest rate of sexual dysfunction among the SSRIs. Potential alternatives to SSRI treatment include bupropion, mirtazapine, vilazodone, vortioxetine, and serotonin-norepinephrine reuptake inhibitors. In the event that a subject responds solely to SSRIs but experiences unwanted sexual side effects, bupropion may be added as an adjunctive medication. Some limited evidence also suggests that saffron may reduce some aspects of sexual dysfunction, excluding ability to reach orgasm.

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Sexual Side-Effects of Contemporary Antidepressants: Review

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670903107575 ◽

2009 ◽

Vol 43 (9) ◽

pp. 795-808 ◽

Cited By ~ 81

Author(s):

Isaac Schweitzer ◽

Kay Maguire ◽

Chee Ng

Keyword(s):

Major Depressive Disorder ◽

Side Effects ◽

Sexual Dysfunction ◽

Depressive Disorder ◽

Sexual Function ◽

Rating Scales ◽

Major Depressive ◽

Double Blind ◽

Direct Assessment ◽

Sexual Side Effects

The aim of the present study was to review the sexual side-effects of contemporary antidepressants in Australia, comparing the selective serotonin re-uptake inhibitors (SSRIs) with venlafaxine, reboxetine, mirtazepine, duloxetine, bupropion, desvenlafaxine and agomelatine. Double-blind, randomized comparative studies of these antidepressants that included assessment of sexual dysfunction with validated rating scales in patients with major depressive disorder were identified from the literature using MEDLINE, EMBASE and PsychINFO databases. Bupropion and duloxetine caused significantly less sexual dysfunction than the SSRIs in short-term studies and reboxetine significantly less in both short- and longer term studies. Bupropion and agomelatine caused significantly less sexual dysfunction than venlafaxine. The evidence for mirtazepine having an advantage over the SSRIs is lacking and there are currently insufficient data for desvenlafaxine. Well-designed comparative studies of contemporary antidepressants with direct assessment of sexual side-effects as the primary outcome measure are scarce. Future studies should be randomized, double-blind, active controlled trials in sexually active subjects with major depressive disorder. There should be direct assessment of sexual function and depression using reliable, validated rating scales before and during treatment. Studies should assess treatment-emergent effects in patients with normal function and resolution of baseline dysfunction over treatment, in both the short and long term. Further research should compare available instruments for measuring sexual function, and include separate analyses of both remitters/non-remitters and male/female subjects.

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Sexual side-effects of antidepressant and antipsychotic drugs

Advances in Psychiatric Treatment ◽

10.1192/apt.9.3.202 ◽

2003 ◽

Vol 9 (3) ◽

pp. 202-210 ◽

Cited By ~ 48

Author(s):

David Baldwin ◽

Andrew Mayers

Keyword(s):

Side Effects ◽

Sexual Dysfunction ◽

Adverse Effects ◽

Sexual Function ◽

Psychotropic Drugs ◽

Antipsychotic Drugs ◽

Well Being ◽

Sexual Expression ◽

Human Relationships ◽

Sexual Side Effects

Adequate sexual expression is essential to many human relationships and provides a sense of physical, psychological and social well-being. Epidemiological and clinical studies show that depression and schizophrenia are associated with impairment of sexual function and satisfaction, even in untreated patients. Most antidepressant and antipsychotic drugs have adverse sexual effects but it is difficult accurately to identify the incidence of treatment-emergent dysfunction, as disturbances can be reliably detected only from systematic enquiries made at baseline and during treatment. Growing awareness of the adverse effects of psychotropic drugs has led to attempts to use adjuvants or substitute treatments to resolve sexual dysfunction. More studies of the effects of antidepressant and antipsychotic drugs on sexual function are needed.

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