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        Sexual Dysfunction Common But Conservatively Treated In Depressed Patients

        A DGReview of :"The ELIXIR study: evaluation of sexual dysfunction in 4557 depressed patients in France"
        Current Medical Research and Opinion

        05/26/2003
        By Emma Hitt, PhD


        One- to two-thirds of patients with depression appear to have sexual dysfunction, and the rate may be somewhat higher in patients treated with antidepressants than in untreated patients, according to new study findings.

        Various factors can confound studies about depression and sexual function, including the presence of underlying sexual dysfunction and the way in which information on sexual function is collected (e.g., spontaneous self-report versus physician questioning), the researchers note.

        Mireille Bonierbale, MD, with the Hôpital Perrens, Bordeaux, France, and colleagues conducted a study of 4557 evaluable patients diagnosed with depression but who were free of sexual dysfunction. Patients were treated for depression at the discretion of their physician and treatment was not influenced by inclusion in the study.

        Information on sexual dysfunction was collected between October 2000 and April 2001. During the first phase of interviewing, patients were questioned about overall well being or treatment side effects. Patients spontaneously reporting sexual dysfunction were invited to answer the Arizona Sexual Experience Scale questionnaire concerning sexual function. In the second phase, patients not previously reporting sexual dysfunction were asked directly by the physician if they had experienced sexual problems, and those who responded affirmatively were then invited to respond to the questionnaire.

        Sexual dysfunction was observed in 35% of those spontaneously reporting problems and in 69% of those with problems identified by physician questioning. Of patients treated with antidepressants, 71% reported sexual dysfunction compared to 65% in untreated patients. The researchers also found that treatment with tianeptine was associated with a lower incidence of sexual dysfunction than was treatment with tricyclic antidepressant or serotonin reuptake inhibitors.

        In 39% of sexual dysfunction cases, physicians changed the antidepressant treatment, but the most frequently adopted approach (in 42% of cases) was to await spontaneous remission.

        "This large population survey reveals the high prevalence of problems of sexual function in patients with major depression," Dr. Bonierbale and colleagues conclude. The add that physicians tend to have a conservative approach to managing sexual dysfunction in depressed patients and that targeted education programmes could improve this issue.
        Curr Med Res Opin 2003;19:2:114-24. "The ELIXIR study: evaluation of sexual dysfunction in 4557 depressed patients in France"

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