Antidepressant-Induced Sexual Dysfunction and Ginkgo Biloba
Sexual dysfunction is a common consequence of treatment with selective serotonin reuptake inhibitor (SSRI) antidepressants (1, 2). Antidote strategies are often used to lessen the sexual difficulty associated with these agents. A variety of medications are reported to reverse SSRI-induced sexual dysfunction. These include cyproheptadine (1, 3, 4), yohimbine (1, 5, 6), amantadine (1, 7, 8), stimulants (9), buspirone (10), bupropion (11, 12), and sildenafil (13–15). In addition, ginkgo biloba has been used to treat antidepressant-induced sexual dysfunction (16). Although the study of gingko biloba had numerous limitations, including problematic statistical analyses (17, 18), it raised hope that ginkgo biloba could be helpful in managing SSRI-induced sexual dysfunction. We report here our experience with use of ginkgo biloba in reversing SSRI-induced sexual dysfunction.
A 1-month trial of ginkgo biloba was prescribed for 22 consecutive patients (nine men and 13 women) seen in a private psychiatric office who complained of SSRI-induced sexual dysfunction. The gingko biloba was purchased at a local health store, and the prescribed dose was 300 mg t.i.d. Oral consent was obtained; written consent was not obtained because the results of this study were not initially for publication. SSRI-induced sexual dysfunction was defined as a new impairment in sexual desire, arousal, or orgasm appearing within 4 weeks of beginning treatment with an SSRI. Ratings of improvement were based on clinical interviews by the patient’s treating psychiatrist.
The 22 patients enrolled in this study described 40 sexual complaints. Three (13.6%) of the 22 patients described at least partial improvement in sexual function while taking ginkgo biloba. None of the nine men and three (23.1%) of the 13 women described improved sexual response. In addition, four (10.0%) of the 40 complaints improved with ginkgo biloba treatment. When analyzed by sex, none of the nine complaints of the men and four (12.9%) of the 31 complaints of the women improved. No side effects of ginkgo biloba treatment were reported.
This brief study demonstrates little reversal of SSRI-induced sexual dysfunction from treatment with ginkgo biloba. There are several obvious limitations to this study, including the lack of a placebo control, a potential variation in product potency, a selection bias, and the lack of a standardized outcome measure. Ginkgo biloba may still hold hope for some patients, perhaps with the selection of a particular brand of product, the use of a higher dose, or use for a longer duration. Nevertheless, this study does not replicate prior findings supporting the use of ginkgo biloba for the treatment of SSRI-induced sexual dysfunction.
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