Substitution of an SSRI With Bupropion Sustained Release Following SSRI-Induced Sexual Dysfunction

Background: We examine changes in sexualfunctioning and depressive symptoms in patients’ transition froma selective serotonin reuptake inhibitor (SSRI), which inducedboth a therapeutic response and sexual dysfunction, to bupropionsustained release (SR) over the course of an 8-week trial.

Method: The study included 11 adults (8 womenand 3 men) who had a DSM-IV diagnosis of major depressivedisorder in remission (Hamilton Rating Scale for Depression[HAM-D] score < 11) and were receiving an SSRI. Depression(using the HAM-D) and sexual dysfunction (using the Changes inSexual Functioning Questionnaire) were assessed at baseline, 2weeks after bupropion SR was added to the current antidepressant(combined treatment), 2 weeks after taper of the SSRI wasinitiated and completed, and after 4 weeks of bupropion SRmonotherapy. T tests were performed to assess changes indepression and sexual function.

Results: Patient participation dropped from theinitial group of 11 at week 2 to 9 at week 4 and to 6 by week 8.Sexual functioning improved from week 0 (baseline) to week 2 andfrom week 2 to week 4. The patients showed no significant changein mean HAM-D scores in weekly comparisons during the studyperiod; 55% of patients completed the substitution withoutsignificant adverse events or recurrence of depressive symptoms.

Conclusion: Bupropion SR as a treatment fordepression also alleviates sexual dysfunction due to SSRItreatment. Results show that sexual functioning improves afterthe addition of bupropion SR to SSRI treatment and continues toimprove, after discontinuation of the SSRI, with bupropion SRtreatment alone.