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Sexual Dysfunction? Try a Different Antidepressant


Leonard DeRogatis, Ph.D.

(September 15, 2006) -- Close to 20 million Americans suffer from some form of clinical depression, and many of them have multiple episodes of depression during their lifetime.

This high prevalence of depression heightens the need for effective treatments. There are currently more than two dozen FDA-approved antidepressants on the market right now, all of which have some degree of proven efficacy.

Unfortunately, one major side effect of most antidepressant medications is sexual dysfunction, with reported rates as high as 70 percent in some studies.

This presents an extremely problematic situation, not only because of the distress and discomfort associated with sexual dysfunction, but also because evidence suggests that more than half of all patients will stop taking their antidepressants because of this side effect.

At a recent scientific meeting, I heard about a study comparing two relatively new antidepressants: Lexapro (escitalopram, one of the selective serotonin reuptake inhibitors or SSRIs) with Cymbalta(duloxetine, one of the class of drugs known as serotonin and noradrenaline reuptake inhibitors or SNRIs).

Rates of sexual dysfunction in hundreds of patients taking one of these two drugs were compared with rates observed in patients taking placebo.

To summarize a series of complex comparisons, in a head-to-head comparison Cymbalta demonstrated substantially lower levels of sexual side effects than did Lexapro. At four weeks and eight weeks of treatment, the Lexapro group demonstrated significantly higher rates of sexual dysfunction than the placebo group, whereas rates for the Cymbalta group were never significantly different than the placebo group.

If you are currently taking an antidepressant and are suffering sexual dysfunction as a result, ask your doctor whether another antidepressant that may have fewer sexual side effects might be suitable for you.

Dr. DeRogatis is a clinical psychologist. He directs the Johns Hopkins Center for Sexual Health and Medicine.

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Last updated: 09/06

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