Patients who take vortioxetine for depression might have fewer sexual side effects than those who take other antidepressants, according to new research published in The Journal of Sexual Medicine.
Antidepressants, particularly serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs), often have negative effects on patients’ sexual functioning. Issues with desire, arousal, and orgasm are common and in some cases, cause patients to stop taking their medication altogether.
Switching to a new antidepressant may help. In this study, scientists from Takeda Development Center Americas and the University of Virginia investigated whether switching to vortioxetine could help relieve sexual side effects while maintaining efficacy for depression.
The trial involved 447 participants (184 men and 263 women) between the ages of 18 and 55 (mean age 40 years) who had been taking an SSRI (citalopram, paroxetine, or sertraline) for a major depressive episode (MDE). The patients had been stable on their medication for at least eight weeks. In addition, each participant was sexually active before the MDE and started having sexual problems after starting medication.
The participants were randomly assigned to stop taking their current antidepressant and take either vortioxetine or escitalopram, an SSRI, for the next eight weeks. Depression symptoms and sexual function were assessed periodically with a variety of assessments, including the Changes in Sexual Functioning Questionnaire Short Form (CSFQ-14).
Overall, men and women taking vortioxetine saw greater improvements in sexual function than those taking escitalopram. At the end of the study, 52% of the vortioxetine group met the criteria for normal sexual function. Forty-four percent of the escitalopram group met this benchmark.
Rates of nausea were much higher in the vortioxetine group, however. One quarter of those patients experienced nausea, compared to 5% of the escitalopram group. Nine patients taking vortioxetine withdrew from the study because of nausea.
Nine patients taking escitalopram reported worsening of sexual problems after starting the drug. This did not occur with any of the patients on vortioxetine.
Both drugs were effective for depressive symptoms.
“The superior improvements in sexual functioning among patients switched to vortioxetine vs. escitalopram may improve compliance with therapy,” the authors hypothesized. They noted, however, that this angle was not tested in the current study.
They added that switching to vortioxetine may be a suitable alternative for patients experiencing treatment-emergent sexual dysfunction.
Resources
The Journal of Sexual Medicine
Jacobsen, Paula L., MS, et al.
“Effect of Vortioxetine vs. Escitalopram on Sexual Functioning in Adults with Well-Treated Major Depressive Disorder Experiencing SSRI-Induced Sexual Dysfunction”
(Full-text. First published online: August 31, 2015)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12980/full