Antidepressant-Induced Sexual Dysfunction among Newer Antidepressants in a Naturalistic Setting

OBJECTIVE: Antidepressants used to treat depression are frequently associated with sexual dysfunction. Sexual side effects affect the patient's quality of life and, in long-term treatment, can lead to non-compliance and relapse. However, studies covering many antidepressants with differing mechanisms of action were scarce. The present study assessed and compared the incidence of sexual dysfunction among different antidepressants in a naturalistic setting. METHODS: Participants were married patients diagnosed with depression, per DSM-IV diagnostic criteria, who had been taking antidepressants for more than 1 month. We assessed the participants via the Arizona Sexual Experiences Scale (ASEX), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI), and assessed their demographic variables, types and dosages of antidepressants, and duration of antidepressant use via their medical records. RESULTS: One hundred and one patients (46 male, 55 female, age 42.2+/-7 years) completed the instruments. Thirteen were taking fluoxetine (mean dose 21.3+/-8.5 mg/day), 24 were taking paroxetine (mean dose 20.4+/-7.2 mg/day), 20 taking citalopram (mean dose 22.1+/-6.5 mg/day), 22, venlafaxine (mean dose 115.7+/-53.2 mg/day) and 22, mirtazapine (mean dose 18+/-8.7 mg/day). Mean ages, sex ratios, and BDI and STAI scores did not differ significantly across antidepressants. A substantial number of participants (46.5%, n=47) experienced sexual dysfunction. The prevalence of sexual dysfunction differed across drugs: citalopram 60% (n=12), venlafaxine 54.5% (n=12), paroxetine 54.2% (n=13), fluoxetine 46.2% (n=6), and mirtazapine 18.2% (n=4). Regression analyses revealed the significant factors for sexual dysfunction were being female, total scores on the BDI and SAI, and type of antidepressant (F=4.92, p<0.0001). Of the antidepressants, the mirtarzapine group's total ASEX score was significantly lower than the scores of the citalopram, fluoxetine, and paroxetine groups. CONCLUSION: The incidence of sexual dysfunction was substantially high during antidepressant treatment. The incidence of sexual dysfunction differed among antidepressants having different mechanisms of action. Our study suggests the need for clinicians to consider the impact of pharmacotherapy on patients' sexual functioning in the course of treatment with antidepressants.

Changes of Cholesterol Level after Treatment in Bipolar Patients / 대한정신약물학회지

OBJECTIVES: Cholesterol interacts with serotonin and it has been found to be associated with some clinical symptoms of mood disorders. There is a paucity of data on first onset bipolar patients and from Asian population. In this study, we compared the total choelsterol (TC) level between the bipolar I patients with a single manic episode (BPSM) and the normal controls, and investigated the relationship between the TC level and treatment response in the BPSM. METHODS: Twenty-five BPSM and thirty normal controls were enrolled in this study. The pretreatment and posttreatment TC levels in the BPSM were measured and comapred to that of normal controls. Young Mania Rating Scale (YMRS) was used for assessing symptom severity in the BPSM. RESULTS: The TC level was significantly lower in the BPSM than in the controls. There were negative correlations between the YMRS scores and the pretreatment TC level in the BPSM. The posttreatment TC level was significantly higher than the pretreatment TC level in the BPSM. CONCLUSION: This study suggests that the TC level can be changed after treatment in bipolar manic patients, although more studies involving different ethnic groups will be needed. Further longitudinal studies will be needed to examine the change of total cholesterol level according to the clinical course of bipolar disorder.

Event-Related Potential P3a and P3b using 3-Stimulus Auditory "Oddball" Paradigm in the Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.

Event-Related Potential P3a and P3b using 3-Stimulus Auditory "Oddball" Paradigm in the Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.