What is it about?

A significant number of patients undergoing treatment with selective serotonin reuptake inhibitors (SSRIs) report sexual dysfunction. SSRI-induced sexual dysfunction adversely affects quality of life and patient adherence to and compliance with treatment regimens. This trial examined the efficacy and safety of adjunctive bupropion in the treatment of SSRI-induced female sexual dysfunction. Sexual function was assessed by using the sexual function domains of the Female Sexual Function Index (primary efficacy outcome measure) and the Clinical Global Impression Scale adapted for sexual function (secondary efficacy outcome measure).

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Why is it important?

Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed to treat depression, anxiety, and premenstrual disorders in women. Female sexual dysfunction (FSD) is a highly prevalent health problem per se. The incidence of sexual dysfunction with SSRIs is high, ranging from 30% to 70%. SSRI treatment-emergent sexual dysfunction is a principal reason for poor treatment adherence and treatment compliance. Up to 90% of patients with SSRI-induced sexual dysfunction will discontinue their medication prematurely. Treatment-emergent sexual dysfunction caused by antidepressants varies considerably across compounds. It should be considered in the choice of the administered drug. Among the sexual side effects most often associated with SSRIs in women are inhibited or decreased sexual desire, inhibited sexual excitement, and difficulty in achieving orgasm.


Sexual dysfunction is a disconcerting side effect of SSRIs that influences a patient’s adherence to an antidepressant treatment schedule. Depression-associated sexual dysfunction is well known. Alternatively, depression can be secondary to sexual dysfunction. Therefore, detailed information about the nature of sexual dysfunction in depressed patients is mandatory. Bupropion blocks the reuptake of norepinephrine and dopamine but is chemically unrelated to the SSRIs. It is effective in the treatment of depression and has not generally been associated with sexual dysfunction. The addition of bupropion to ongoing SSRI therapy to lower or ameliorate SSRI-induced sexual dysfunction is strongly supported by both controlled and open trials.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

Read the Original

This page is a summary of: Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study, Journal of Psychopharmacology, January 2010, SAGE Publications, DOI: 10.1177/0269881109351966.
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