To evaluate the possible influence of buspirone on sexual dysfunction in depressed patients treated with a selective serotonin reuptake inhibitor (SSRI), we analyzed data from a placebo-controlled trial designed to explore the efficacy of buspirone as add-on treatment for patients not responding to an SSRI alone. At baseline, all patients met the criteria for a major depressive episode according to DSM-IV and had received citalopram or paroxetine during a minimum of 4 weeks without responding to the treatment. Buspirone (flexible dosage, 20-60 mg/day) or placebo was added to the SSRI for 4 weeks; the mean daily dose of buspirone at endpoint was 48.5 mg (SD = 1.0). Sexual dysfunction was evaluated using a structured interview. Before starting medication with buspirone or placebo, 40% (47 of 117) reported at least one kind of sexual dysfunction (decreased libido, ejaculatory dysfunction, orgasmic dysfunction). During the 4 weeks of treatment, approximately 58% of subjects treated with buspirone reported an improvement with respect to sexual function; in the placebo group, the response rate was 30%. The difference between placebo and active drug treatment was more pronounced in women than in men. The response was obvious during the first week, with no further improvement during the course of the study. It is suggested that the effect of buspirone on sexual dysfunction is a result of a reversal of SSRI-induced sexual side effects rather than of an anti-depressant effect of the drug. (J Clin Psychopharmacol 1999;19:268-271)
(Landen, Agren, Fahlen) Institute of Clinical Neuroscience, Departments of Psychiatry and Neurochemistry, and (Eriksson) Institute of Physiology and Pharmacology, Department of Pharmacology, Goteborg University, Goteborg, Sweden
Received February 17, 1998; accepted after revision July 2, 1998.
Address requests for reprints to: Mikael Landen, MD, Goteborg University, Institute of Clinical Neuroscience, Department of Psychiatry and Neurochemistry, Sahlgrenska University Hospital/Molndal, S-431 80 Molndal, Sweden. Address e-mail to: firstname.lastname@example.org.