SEXUOLOGY / SYSTEMATIC REVIEW/META-ANALYSIS
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Sexual dysfunction (SD) is known to be associated with selective serotonin reuptake inhibitors (SSRIs). To determine the effect of different SSRIs on SD development in males, particularly erectile dysfunction (ED), a systematic review was conducted according to PRISMA guidelines.

Material and methods:
Literature, in English language, published between January 2009 and September 2019 was searched using two electronic databases, PubMed and EMBASE. Studies were screened according to the predefined inclusion-exclusion criteria. The bibliographies of the included articles were screened to identify any relevant articles.

Results:
A total of ten articles were included (8/811 articles searched; two from bibliographies of eight included articles). Treatment-emergent SD, particularly ED was observed in male participants, although the ED incidence was low, less than 2%. SSRIs – fluoxetine, escitalopram, and citalopram – showed a higher risk of ED than other SSRIs.

Conclusions:
The findings indicated a positive association between SSRIs and SD. However, evidence supporting a strong link between SSRIs and ED was insufficient.
REFERENCES (39)
1.
Bromet E, Andrade L, Hwang I, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 9: 90.
 
2.
Reichenpfader U, Gartlehner G, Morgan LC, et al. Sexual dysfunction associated with second-generation antidepressants in patients with major depressive disorder: results from a systematic review with network meta-analysis. Drug Saf 2014; 37: 19-31.
 
3.
The World Health Report 2001: Mental Health: New understanding, New hope. France, Organization WH.
 
4.
Lim GY, Tam W, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep 2018; 8: 2861.
 
5.
Armstrong C. APA releases guidelines on treatment of patients with major depressive disorder. Am Fam Physician 2011; 83: 1219-27.
 
6.
Gauthier G, Guerin A, Zhdanava M, et al. Treatment patterns, healthcare resource utilization, and costs following first-line antidepressant treatment in major depressive disorder: a retrospective US claims database analysis. BMC Psychiatry 2017; 17: 222.
 
7.
Khazaie H, Rezaie L, Payam NR, Najafi F. Antidepressant-induced sexual dysfunction during treatment with fluoxetine, sertraline and trazodone: a randomized controlled trial. Gen Hosp Psychiatry 2015; 37: 40-5.
 
8.
Qaseem A, Snow V, Denberg TD, Forciea MA, Owens DK, Clinical Efficacy Assessment Subcommittee of American College of P. Using second-generation antidepressants to treat depressive disorders: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2008; 149: 725-33.
 
9.
Saltiel PF, Silvershein DI. Major depressive disorder: mechanism-based prescribing for personalized medicine. Neuropsychiatr Dis Treat 2015; 11: 875-88.
 
10.
Jing E, Straw-Wilson K. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: a narrative literature review. Ment Health Clin 2016; 6: 191-6.
 
11.
Arroll B, Macgillivray S, Ogston S, et al. Efficacy and tolerability of tricyclic antidepressants and SSRIs compared with placebo for treatment of depression in primary care: a meta-analysis. Ann Fam Med 2005; 3:449-56.
 
12.
Gartlehner G, Hansen RA, Morgan LC, et al. Comparative benefits and harms of second-generation antidepressants for treating major depressive disorder: an updated meta-analysis. Ann Intern Med 2011; 155: 772-85.
 
13.
Osis L, Bishop JR. Pharmacogenetics of SSRIs and sexual dysfunction. Pharmaceuticals 2010; 3: 3614-28.
 
14.
Williams JW Jr, Mulrow CD, Chiquette E, Noel PH, Aguilar C, Cornell J. A systematic review of newer pharmacotherapies for depression in adults: evidence report summary. Ann Intern Med 2000; 132: 743-56.
 
15.
Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug Healthc Patient Saf 2010; 2: 141-50.
 
16.
Thapa M, Petrakis I, Ralevski E. A comparison of antidepressants with/without naltrexone on sexual side effects. J Dual Diagn 2017; 13: 230-5.
 
17.
Corona G, Ricca V, Bandini E, et al. Selective serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Med 2009; 6: 1259-69.
 
18.
Clayton AH, Croft HA, Handiwala L. Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad Med 2014; 126: 91-9.
 
19.
La Torre A, Duffy D, Conca A. Sexual dysfunction related to psychotropic drugs: a critical review – part I: antidepressants. Pharmacopsychiatry 2013; 46: 191-9.
 
20.
Keltner NL, McAfee KM, Taylor CL. Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspect Psychiatr Care 2002; 38: 111-6.
 
21.
Reisman Y. Sexual Consequences of post-SSRI syndrome. Sex Med Rev 2017; 5: 429-33.
 
22.
Clayton AH, Gommoll C, Chen D, Nunez D, Mathews M. Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial. Int Clin Psychopharmacol 2015; 30: 216-23.
 
23.
Simopoulos E, Trinidad AC. Male erectile dysfunction: integrating psychopharmacology and psychotherapy. Gen Hosp Psychiatry 2013; 35: 33-8.
 
24.
Prabhakar D, Balon R. How do SSRIs cause sexual dysfunction? Curr Psychiatry 2010; 9: 30-4.
 
25.
Montejo-Gonzàlez AL, Llorca G, Izquierdo JA, et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997; 23: 176-97.
 
26.
Moher D, Liberati A, Tetzlaff J, Altman DG; the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-9.
 
27.
Rahimi R, Nikfar S, Abdollahi M. Selective serotonin reuptake inhibitors for the managementof irritable bowel syndrome: a meta-analysis of randomized controlled trials. Arch Med Sci 2008; 4: 71-6.
 
28.
Crawford AA, Lewis S, Nutt D, et al. Adverse effects from antidepresssant treatment: randomised controlled trial of 601 depressed individuals. Psychopharmacology 2014; 231: 2921-31.
 
29.
Mathews M, Gommoll C, Chen D, et al. Efficacy and safety of vilazodone 20 and 40 mg in major depressive disorder: a randomized, double-blind, placebo-controlled trial. Int Clin Psychopharmacol 2015; 30: 67-74.
 
30.
Croft HA, Pomara N, Gommoll C, et al. Efficacy and safety of vilazodone in major depressive disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 2014; 75: e1291-8.
 
31.
Gelenberg AJ, Dunner DL, Rothschild AJ, et al. Sexual functioning in patients with recurrent major depressive disorder enrolled in the PREVENT study. J Nerv Ment Dis 2013; 201: 8.
 
32.
Boulenger JP, Loft H, Olsen CK. Efficacy and safety of vortioxetine (Lu AA21004), 15 and 20 mg/day: a randomized, double-blind, placebo-controlled, duloxetine-refernced study in the acute treatment of adult patients with major depressive disorder. Int Clin Psychopharmacol 2014; 29: 138-49.
 
33.
Jacobsen PL, Mahableshwarkar A, Chen Y, et al. Effect of vortixetine vs. escitalopram on sexual functioning in adults with well-treated major depressive disorder experiencing SSRI-induced sexual dysfunction. J Sex Med 2015; 12: 2036-48.
 
34.
Jacobsen PL, Harper L, Chrones L, et al. Safety and tolerability of vortioxetine (15 and 20 mg) in patients with major depressive disorder: results of an open-label, flexible-dose, 52-week extension study. Int Clin Psychopharmacol 2015; 30: 255-64.
 
35.
Williams VSL, Edin H, Hogue SL, Fehnel SE, Baldwin DS. Prevalence and impact of antidepressant-associated sexual dysfunction in three European countries: replication in a cross-sectional patient survey. J Psychopharmacol 2010; 24: 489-96.
 
36.
Jacobsen PL, Zhong W, Nomikos G, Clayton AH. Paroxetine, but not vortioxetine, impairs sexual functioning compared with placebo in healthy adults: a randomized, controlled trial. J Sex Med 2019; 16: 1638-49.
 
37.
Weber P, Schmidutz F, Ficklscherer A, Steinbrück A, Jansson V, Dürr HR. Does total joint arthroplasty impair erectile function? Arch Med Sci 2018; 14: 1087-92.
 
38.
Du XL, Liu L, Song W, et al. Association between gout and erctile dysfunction: a systematic review and meta-analysis. PLoS One 2016; 11: e0168784.
 
39.
Aronow WS, Shamliyan TA. Effects of antidepressants on QT interval in people with mental disorders. Arch Med Sci 2020; 16: 727-41.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top