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Managing strategies for antidepressant-related sexual dysfunction. results from a multicentric, pragmatic study with 2000 patients in spain: the SALSEX-I study

Published online by Cambridge University Press:  16 April 2020

A.L. Montejo
Affiliation:
Psychiatry, University Hospital of Salamanca, University of Salamanca, Salamanca, Spain
S. Majadas
Affiliation:
Spanish Association of Sexuality and Mental Health (AESexSAME), Dpto. Psiquiatría y Psicología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
J. Calama
Affiliation:
Service of Psychiatry, University Hospital of Salamanca, Salamanca, Spain
A.I. Hernandez
Affiliation:
Service of Psychiatry, University Hospital of Salamanca, Salamanca, Spain

Abstract

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Introduction

Antidepressant-related sexual dysfunction (ADr-SD) is the most frequent and long-lasting adverse event, often underestimated and rarely spontaneously communicated. Strategies to manage it haven’t been explored to date.

Study aim

To explore ADr-SD clinical management in regular practice.

Objectives

  1. 1. To stablish the prevalence of SD in patients following antidepressant treatment.

  2. 2. To describe the therapeutic interventions used when SD is detected.

Methods

Cross-sectional, multicentric and naturalistic study. Patients taking antidepressant for at least two months without previous SD were included. SD was evaluated with the specific questionnaire PR-Sex-DQ (SALSEX, Montejo et al 2001).

Results

1988 out of 2000 patients recruited resulted eligible for the analysis. According to PRSexDQ scores SD was present in 87.5% ot the sample. Only 44.2% communicated it spontaneusly. 66.2% reported regular to poor tolerance of SD and 19.6% had thought about discontinuing treatment due to it. Regarding the therapeutic interventions used for managing ADr-SD, waiting for its spontaneus remission was the most frequent strategy reported (36.8%), followed by changing the antidepressant (32.5%) and reducing the dosage (18.5%); 5% chosed “weekend holidays”, 4% discontinued the antidepressant, 2.5% associated another antidepressant and 1.3% added a 5-phosphodiesterase inhibitor. Bupropion and mirtazapine were the antidepressants most frequently selected for the switching and association strategies.

Conclusions

These results study highlight the high rates of SD related to antidepressants and its potential association with non-adherence to treatment. Despite this unfortunatelly clinicians do prefer to wait rather than performing any active strategy to manage this adverse event.

Type
P03-95
Copyright
Copyright © European Psychiatric Association 2011
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