Prevalence of Sexual Dysfunction Among Newer Antidepressants
Abstract
BACKGROUND: Sexual dysfunction commonly occurs during antidepressant treatment. However, the reported rates of sexual dysfunction vary across antidepressants and are typically underreported in product literature. The objectives of this study were (1) to estimate the prevalence of sexual dysfunction among patients taking newer antidepressants (bupropion immediate release [IR], bupropion sustained release [SR], citalopram, fluoxetine, mirtazapine, nefazodone, paroxetine, sertraline, venlafaxine, and venlafaxine extended release [XR]) and (2) to compare physician-perceived with patient-reported prevalence rates of antidepressant-associated sexual dysfunction. METHOD: This cross-sectional, observational study was conducted in 1101 U.S. primary care clinics. Adult outpatients (4534 women and 1763 men) receiving antidepressant monotherapy were enrolled. The prevalence of sexual dysfunction was measured using the Changes in Sexual Functioning Questionnaire. RESULTS: In the overall population, bupropion IR (22%) and SR (25%) and nefazodone (28%) were associated with the lowest risk for sexual dysfunction, whereas selective serotonin reuptake inhibitor (SSRI) antidepressants, mirtazapine, and venlafaxine XR were associated with higher rates (36%-43%). In a prospectively defined subpopulation unlikely to have predisposing factors for sexual dysfunction, the prevalence of sexual dysfunction ranged from 7% to 30%, with the odds of having sexual dysfunction 4 to 6 times greater with SSRIs or venlafaxine XR than with bupropion SR. Physicians consistently underestimated the prevalence of antidepressant-associated sexual dysfunction. CONCLUSION: Ours is the first study to assess sexual dysfunction across the newer antidepressants using consistent methodology and a validated rating scale. Overall, SSRIs and venlafaxine XR were associated with higher rates of sexual dysfunction than bupropion or nefazodone. Because antidepressant-associated sexual dysfunction is considerably underestimated by physicians, greater recognition and education are imperative when prescribing antidepressant treatment.
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Although sexual dysfunction has been reported with all classes of antidepressants, SSRIs are associated with higher rates.
“Although sexual dysfunction has been reported with all classes of AD (549), SSRIs are associated with higher rates (550-552).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [550]
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- Authors
- Clayton, A. H., Pradko, J. F., Croft, H. A., Montano, C. B., Leadbetter, R. A., Bolden-Watson, C., Bass, K. I., Donahue, R. M. J., Jamerson, B. D., & Metz, A.
- Affiliations
- University of Virginia (US)
- University of Connecticut (US)
- GlaxoSmithKline (United States) (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2002-04-15
- Volume
- 63
- Issue
- 4
- Pages
- 357-366
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2136137449
- Cited by
- 542
- References
- 12
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 11 · 2023: 10 · 2022: 20 · 2021: 14 · 2020: 11 · 2019: 16 · 2018: 14 · 2017: 14 · 2016: 13 · 2015: 28 · 2014: 31 · 2013: 34 · 2012: 15
- FWCI
- 18.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- newer antidepressants, selective serotonin reuptake inhibitors, venlafaxine extended release, bupropion, nefazodone, mirtazapine, primary care outpatients
- MeSH terms
- Venlafaxine Hydrochloride, Adult, Antidepressive Agents, Attitude of Health Personnel, Attitude to Health, Cross-Sectional Studies, Cyclohexanols, Delayed-Action Preparations, Depressive Disorder, Female, Humans, Male, Physicians, Family, Primary Health Care, Prospective Studies, Research Design, Risk Factors, United States, Prevalence, Logistic Models, Selective Serotonin Reuptake Inhibitors, Sexual Dysfunctions, Psychological
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