0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
Sexual Functioning With Selective Serotonin Reuptake Inhibitors
RICHARD BALON, M.D.
Am J Psychiatry 1999;156:807-808.

To the Editor: Lisa A. Piazza, M.D., and colleagues (1) presented interesting findings on sexual functioning in chronically depressed patients treated with selective serotonin uptake inhibitors (SSRIs). However, their findings raise several questions.

Results of presumably 25 sexually active patients are analyzed; however, only 19 patients were involved in a sexual relationship. Does this mean that the remaining six patients were using masturbation as their predominant sexual activity?

Results are presented in the form of means of items on the Arizona Sexual Experience Scale (2). However, the data on frequency of sexual dysfunction are missing. Antidepressants do not usually induce sexual dysfunction in all patients. For instance, in another longitudinal study (3), only 35% of patients on paroxetine showed sexual dysfunction after 6 weeks of treatment. In view of this fact, and of the sometimes high standard deviations of Arizona Sexual Experience Scale items (1), it would be helpful to report the data only in patients who reported SSRI-induced sexual dysfunction. Most of the differences between baseline means and end-of-treatment means are small (from 0.54 to 1.18 in men and from 0.09 to 1.07 in women). Thus, severe worsening or improvement of sexual functioning in a very few individuals could account for the group difference.

The findings on gender differences in treatment-associated sexual dysfunction should also be interpreted with caution. South Carolina researchers, in their longitudinal treatment studies with SSRIs, found that, for women, an orgasm delay gradually improved over 3 months but for men, persisted almost unchanged (4). However, in another of their reports, women tended to be anorgasmic more than men at months 1 and 2 (5). In both reports, the patient population was larger (N=62 and N=75) but not diagnostically homogeneous.

It is obvious that we need double-blind, placebo-controlled studies of sexual dysfunction in larger population samples with use of standardized measures to clarify issues raised by smaller studies.

Piazza LA, Markowitz JC, Kocsis JH, Leon AC, Portera L, Miller NL, Adler D: Sexual functioning in chronically depressed patients treated with SSRI antidepressants: a pilot study. Am J Psychiatry 1997; 154:1757–  1759
 
McGahuey CA, Gelenberg AJ, Laukes CA, Manber R, Mc­Knight KM, Moreno FA, Delgado PL: The Arizona Sexual Experience Scale: validity and reliability, in New Research Program and Abstracts, 150th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1997, p 116
 
Ontiveros A, Valdes M, Costilla A: Double-blind comparison of sexual dysfunction on imipramine and paroxetine, in Abstracts of the 51st Annual Convention and Scientific Meeting of the Society of Biological Psychiatry. Biol Psychiatry  1996; 39:618–619
 
Grimes JB, Labbate LA, Hines AH: Sexual dysfunction induced by SSRIs, in New Research Program and Abstracts, 149th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1996, p 92
 
Labatte LA, Grimes JB, Hines AH, Oleshansky MA: Sexual dysfunction induced by SSRIs, in Paper Session Abstracts, 150th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1997, pp 15–16
 
+

References

Piazza LA, Markowitz JC, Kocsis JH, Leon AC, Portera L, Miller NL, Adler D: Sexual functioning in chronically depressed patients treated with SSRI antidepressants: a pilot study. Am J Psychiatry 1997; 154:1757–  1759
 
McGahuey CA, Gelenberg AJ, Laukes CA, Manber R, Mc­Knight KM, Moreno FA, Delgado PL: The Arizona Sexual Experience Scale: validity and reliability, in New Research Program and Abstracts, 150th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1997, p 116
 
Ontiveros A, Valdes M, Costilla A: Double-blind comparison of sexual dysfunction on imipramine and paroxetine, in Abstracts of the 51st Annual Convention and Scientific Meeting of the Society of Biological Psychiatry. Biol Psychiatry  1996; 39:618–619
 
Grimes JB, Labbate LA, Hines AH: Sexual dysfunction induced by SSRIs, in New Research Program and Abstracts, 149th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1996, p 92
 
Labatte LA, Grimes JB, Hines AH, Oleshansky MA: Sexual dysfunction induced by SSRIs, in Paper Session Abstracts, 150th Annual Meeting of the American Psychiatric Association. Washington, DC, APA, 1997, pp 15–16
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Web of Science® Times Cited: 3

Related Content
Books
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 20.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 17.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 17.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 17.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 25.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles