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Sexual
Problems Common
With Antidepressant Use
NEW
ORLEANS (Reuters Health) - Sexual problems linked with antidepressant
use may be more common than widely believed, according to research
presented here at the annual meeting of the American Psychiatric
Association.
In a study
of nearly 6,300 patients on newer types of antidepressants, almost
40% reported sexual dysfunction--a rate nearly twice what the
patients' physicians predicted.
Dr. Anita
L. H. Clayton of the University of Virginia in Charlottesville
and her colleagues used questionnaires to gauge primary care doctors'
estimates of sexual problems related to antidepressants, and their
actual occurrence.
The physicians
said that they expected 20% of patients on antidepressants to
have some type of sexual problem. However, among the patients
surveyed, 37% of those on newer types of antidepressants such
as fluoxetine (Prozac) reported problems.
``Doctors
have been hesitant to discuss antidepressant-related sexual dysfunction,
often because they are afraid that patients will not want to talk
about it,'' Clayton told Reuters Health. ''However, 70% of patients
who were asked to participate in the survey chose to do so.''
Because both
patients and physicians are reluctant to discuss sexual problems,
the topic is often never mentioned, she noted. However, the development
of a sexual problem, such as impotence, can be discouraging enough
to some patients that they stop their medications.
Patients need
to bring up sexual problems directly, Clayton said. Most physicians
will be willing to find a solution to the problem, and often the
doctor can prescribe a different medication or adjust the dose.
If the physician
seems uninterested or unwilling to help, Clayton said, ``find
a different doctor.''
In this study,
she and colleagues found that several circumstances added to a
patient's risk of sexual problems after starting antidepressant
therapy. People were more likely to have problems if they were
age 50 or older, less educated, not fully employed, or smoked
6 to 20 cigarettes per day.
Surprisingly,
married people were also more likely to report problems, perhaps
because married patients were also likely to be older, said Clayton.
Patients who were simultaneously taking other medications also
stood a greater chance of experiencing sexual dysfunction.
In addition,
certain antidepressants were more likely to be associated with
sexual problems. All of the drugs in a class of antidepressants
known as selective serotonin-reuptake inhibitors (SSRIs) were
highly associated with sexual dysfunction.
Fluoxetine
(Prozac), paroxetine (Paxil) and sertraline (Zoloft) are examples
of SSRIs. Bupropion (Wellbutrin) and nefazodone (Serzone), antidepressants
that act differently on the brain than do the SSRIs, were much
less likely to be associated with sexual dysfunction.
The study
was funded by GlaxoSmithKline, which manufactures several SSRIs
as well as bupropion.
Reference
Source 89
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