Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care.

The purpose of this study was to prospectively examine the occurrence and severity of sexual dysfunction symptoms in depressed patients before and after 6 months of treatment with selective serotonin reuptake inhibitors. The study was part of a randomized, double-blind, controlled trial of sertraline or citalopram in patients with a DSM-III-R major depressive disorder treated by general practitioners. Three hundred eight patients (221 women and 87 men) were assessed at baseline and after 6 months of treatment by means of the Montgomery-Asberg Depression Rating Scale and five items from the Utvalg for Kliniske Undersogelser (UKU) Side Effect Scale covering different aspects of sexual functioning. As measured by the UKU Side Effect Scale, sexual desire and mean total score significantly improved in women, and sexual desire improved in men. Men reported no change in orgasmic dysfunction, erectile dysfunction, or mean total score, but there was a trend toward worsening of ejaculatory dysfunction. However, in the subgroup of women who reported no sexual problems at baseline, 11.8% reported decreased sexual desire, and 14.3% reported orgasmic dysfunction at week 24. The corresponding figures in the same subgroup of men were 16.7% and 18.9%, respectively, and as many as 25% experienced ejaculatory dysfunction after 24 weeks. There were no statistically significant differences between sertraline and citalopram in the magnitude or frequency of adverse sexual side effects.