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Randomized Controlled Trial
. 2011 Oct;12(7):528-38.
doi: 10.3109/15622975.2011.559270. Epub 2011 Mar 9.

Sexual dysfunction during treatment with serotonergic and noradrenergic antidepressants: clinical description and the role of the 5-HTTLPR

Jana Strohmaier  1 , Stefan Wüst, Rudolf Uher, Neven Henigsberg, Ole Mors, Joanna Hauser, Daniel Souery, Astrid Zobel, Mojca Z Dernovsek, Fabian Streit, Christine Schmäl, Dejan Kozel, Anna Placentino, Anne Farmer, Peter McGuffin, Katherine J Aitchison, Marcella Rietschel
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Free PMC article
Randomized Controlled Trial

Sexual dysfunction during treatment with serotonergic and noradrenergic antidepressants: clinical description and the role of the 5-HTTLPR

Jana Strohmaier et al. World J Biol Psychiatry. 2011 Oct.
Free PMC article

Abstract

Objectives: Sexual dysfunction (SD) is a frequently reported side-effect of antidepressant treatment, particularly of selective serotonin reuptake inhibitors (SSRIs). In the multicentre clinical and pharmacogenetic GENDEP study (Genome-based Therapeutic Drugs for Depression), the effect of the serotonin transporter gene promoter polymorphism 5-HTTLPR on sexual function was investigated during treatment with escitalopram (SSRI) and nortriptyline (tricyclic antidepressant).

Methods: A total of 494 subjects with an episode of DSM-IV major depression were randomly assigned to treatment with escitalopram or nortriptyline. Over 12 weeks, depressive symptoms and SD were measured weekly with the Montgomery-Asberg Depression Rating Scale, the Antidepressant Side-Effect Checklist, the UKU Side Effect Rating Scale, and the Sexual Functioning Questionnaire.

Results: The incidence of reported SD after 12 weeks of treatment was relatively low, and did not differ significantly between antidepressants (14.9% escitalopram, 19.7% nortriptyline). There was no significant interaction between the 5-HTTLPR and antidepressant on SD. Improvement in depressive symptoms and younger age were both associated with lower SD. The effect of age on SD may have been moderated by the 5-HTTLPR.

Conclusions: In GENDEP, rates of reported SD during treatment were lower than those described in previous reports. There was no apparent effect of the 5-HTTLPR on the observed decline in SD.

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Figures

Figure 1
Figure 1
Time course of reported sexual dysfunction (ASEC item 12) over the 12-week study period for escitalopram and nortriptyline.
Figure 2
Figure 2
Time course of reported sexual dysfunction (ASEC item 12) over the 12-week study period according to the change in MADRS (Montgomery-Asberg Depression Rating Scale) in subjects with scores £18 points and >18 points.
Figure 3
Figure 3
Interaction effect of the 5-HTTLPR genotype (s/s, s/l, 1/1) and age on reported sexual dysfunction (ASEC item 12).
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