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      Nefazodone Plus Psychotherapy Can Improve Sexual Interest, Function In Patients With Major Depression

      A DGReview of :"Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination."
      Journal of Clinical Psychiatry

      09/13/2002
      By Andrew A. Skolnick


      Combining the antidepressant nefazodone with psychotherapy can improve sexual interest and function in patients with major clinical depression.

      Changes in sexual interest, satisfaction and function are frequently associated with major depression as well as the use of some antidepressant treatments.

      John Zajecka, MD, and colleagues at Rush-Presbyterian-St. Luke's Medical Center, in Chicago, Illinois, United States, compared the effects of nefazodone, psychotherapy or both treatments combined on the sexual interest, satisfaction and function in 681 outpatients with chronic major depression.

      The patients were randomly assigned to 12 weeks of treatment with nefazodone, the Cognitive Behavioral Analysis System of Psychotherapy or both treatments. The researchers used the Modified Rush Sexual Inventory to assess each patient's sexual functioning and the 24-item Hamilton Rating Scale for Depression to measure depressive symptoms.

      At baseline, 65 percent of men and 48 percent of women reported some sexual dysfunction. The investigators noted statistically significant linear improvement in sexual interest/satisfaction across all three treatment groups. They also reported significant improvement in sexual function across all three treatment groups of women.

      Controlling for depressive symptoms and gender, they found the combined treatment produced greater improvement in total sexual interest/satisfaction than psychotherapy alone (p = .007), but was not significantly different from nefazodone alone.

      Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning, the researchers reported.

      "Chronic depression is associated with high rates of sexual dysfunction," they concluded. "Treatment with nefazodone, Cognitive Behavioral Analysis System of Psychotherapy, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment."
      J Clin Psychiatry 2002; 63: 709-716. "Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination."

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