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Antidepressants such as SSRI and SNRI are associated to sexual dysfunction (SD). Agomelatine, an antidepressant with an unique and different mechanism of action, didn’t produce SD in patients and healthy volunteeers (Montejo et al, 2010).
To evaluate the effectiveness of switching to agomelatine in patient's experiencing SD related to previous antidepressant treatment (AD-SD).
Observational prospective study of 2-6 months follow-up. Adult sexually active patients presenting AD-SD and switched to agomelatine monotherapy were included. SD was evaluated with the change at endpoint in the validated and specific questionnaire PR-Sex-DQ-SALSEX (Montejo et al, 2001).
51 patients were included. All of them presented moderate to severe SD at inclusion. Previous AD treatment was an SSRI (63.4%) or SNRI (36.6%). Mean time of follow-up was 10.38 weeks (Sd: 5.20). Mean dose of agometine was 28.43 mg/day (Sd: 10.02). Sexual dysfunction (sexual interest, orgasm delay, anorgasmia and arousal problems) improved after switching to agomelatine, as shown by the significant reduction in PR-Sex-DQ-SALSEX score (global and by items) at endpoint (p<0.001, Wilcoxon test). At endpoint 44.9% of the sample had resolved their SD. Moderate-severe SD was present only in 18.4%. 13.9% discontinued agomelatine due to lack of efficacy and 9.7% because tolerability issues, specially associated to discontinuation syndrome.
In our sample global and every domain of SD improved significantly after switching to agomelatine, what makes it an apparent successful option to manage Antidepressant-related Sexual Dysfunction. A gradual switching is suggested in order to avoid treatment failure due to discontinuation syndrome.
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