A study examining patients who use antidepressants revealed that 19% of individuals without prior sexual issues reported encountering sexual problems related to the usage of at least one antidepressant. The paper was published in the Journal of Affective Disorders Reports.
Depression, or major depressive disorder, is a serious mental health condition characterized by persistent feelings of sadness, emptiness, or hopelessness, along with a lack of interest or pleasure in activities that were once enjoyed. Symptoms can include changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and thoughts of death or suicide.
Depression can lead to significant impairments in daily functioning, adversely impacting work, and social relationships. The exact cause of depression is not known, but it is believed to result from a combination of genetic, biological, environmental, and psychological factors. Main methods of treatment include psychotherapy and a type of medications called antidepressants.
Antidepressants work by altering the balance of neurotransmitters in the brain, chemicals which are involved in regulating mood and emotions. There are several types of antidepressants, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors. Each of these types has a different mechanism of action, but individual antidepressants also have different side effects.
Study author Judith J. Stephenson and her colleagues noted that many individuals cease using antidepressants despite ongoing depression symptoms. It’s estimated that nearly half of the patients do not follow their prescribed medication plans, citing reasons such as the medication’s inefficacy, inadequate doctor-patient communication, cost, and notably, side effects.
One of the most often reported side effects of antidepressants is treatment-emergent sexual dysfunction. This condition can adversely impact the patient’s life quality and exacerbate social challenges.
With this in mind, the study authors conducted an online survey of users of antidepressants to better understand the reasons for continuing therapy, switching to a different antidepressant, and discontinuation, but also the impact of treatment-emergent sexual dysfunction from the perspective of patients with depression.
The survey involved 900 people aged 18 to 64 with major depressive disorder, categorizing them based on their antidepressant use over the past year into continuers (62%), switchers (33%), and discontinuers (5%), with a significant female majority (78%).
Participants reported the type of antidepressants they use, how often they use them, and their sexual functioning before and during antidepressant therapy. They also completed assessments of depressive symptoms (the Patient Health Questionnaire Depression Scale), sexual functioning (the Changes in Sexual Functioning Questionnaire), and satisfaction with their antidepressant treatment (the Treatment Satisfaction Questionnaire for Medication, version 1.4).
On average, those who had used antidepressants in the past 12 months had tried 1.4 different types. Sixty-seven percent used one antidepressant, 26% used two different types, and 5% used three. SSRIs were the most commonly used antidepressant type, with 47% of participants using them. Continuers more frequently used SSRIs compared to switchers.
56% of participants reported not experiencing sexual problems prior to their depression diagnosis. Of these individuals, 19% reported experiencing sexual problems after the start of the treatment (treatment-emergent sexual dysfunction). This percentage was similar among continuers and switchers. All of these individuals attributed the sexual problems they had to at least one of the antidepressants they were taking.
Fifty-six percent of participants reported no sexual problems before their diagnosis of depression. Among these individuals, 19% experienced sexual problems after starting treatment (treatment-emergent sexual dysfunction). This percentage was consistent among both continuers and switchers. All affected individuals attributed their sexual problems to at least one of the antidepressants they were taking.
“Based on the surveyed patients’ perspectives, we found that HCP [health care professionals’] recommendations, treatment efficacy, and medication side effects play an important role in AD [antidepressant] continuation, switching, or discontinuation when treating patients with MDD [major depressive disorder]. Primary reasons to switch or discontinue ADs were treatment dissatisfaction, lack of efficacy, and occurrence of side effects. Sexual problems as a symptom of depression were prevalent prior to initiating treatment among discontinuers, and they were often not discussed with an HCP due to the stigma of sexual disfunction,” the study authors concluded.
The study sheds light on the experiences of antidepressant use. However, the study authors note that study participants were all commercially insured and primarily employed patients with depression. Studies on a broader sample of patients might not yield equal results.
The paper, “Antidepressant Use and Treatment-Emergent Sexual Dysfuction Among Patients With Major Depressive Disorder: Results From an Internet-Based Survey Study,” was authored by Judith J. Stephenson, Maelys Touya, Lambros Chrones, Shivani A. Pandya, Chia-Chen Teng, and Anita H. Clayton.
