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Strategies for managing sexual dysfunction induced by antidepressant medication

  1. Matthew J Taylor1,*,
  2. Lisa Rudkin2,
  3. Philippa Bullemor-Day1,
  4. Jade Lubin3,
  5. Christopher Chukwujekwu4,
  6. Keith Hawton5

Editorial Group: Cochrane Common Mental Disorders Group

Published Online: 31 MAY 2013

Assessed as up-to-date: 1 JAN 2013

DOI: 10.1002/14651858.CD003382.pub3


How to Cite

Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD003382. DOI: 10.1002/14651858.CD003382.pub3.

Author Information

  1. 1

    Institute of Psychiatry, King's College London, Department of Psychosis Studies, London, UK

  2. 2

    Bradford Community NHS Trust, Assertive Outreach, Bradford, UK

  3. 3

    Institute of Psychiatry, Department of Psychosis Studies, London, UK

  4. 4

    Coventry and Warwickshire NHS partnership trust, Old Age Psychiatry, Rugby, UK

  5. 5

    Warneford Hospital, Centre for Suicide Research, University Department of Psychiatry, Oxford, UK

*Matthew J Taylor, Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. matthew.j.taylor@kcl.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (conclusions changed)
  2. Published Online: 31 MAY 2013

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[Figure 1]
Figure 1. Study flow diagram
[Figure 2]
Figure 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 3]
Figure 3. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 4]
Figure 4. Forest plot of comparison 1: sildenafil vs placebo, outcome: 1.1 endpoint International Index of Erectile Function (IIEF) scores
[Figure 5]
Figure 5. Forest plot of comparison 1: sildenafil vs placebo, outcome: 1.5 endpoint Arizona Sexual Experience Scale (ASEX) total scores
[Figure 6]
Figure 6. Forest plot of comparison 3: bupropion vs placebo, outcome: 3.1 endpoint scale total scores
[Figure 7]
Figure 7. Forest plot of comparison 3: bupropion vs placebo, outcome: 3.2 response (as defined by study)
[Analysis 1.1]
Analysis 1.1. Comparison 1 Sildenafil vs placebo, Outcome 1 Endpoint International Index of Erectile Function (IIEF) scores.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Sildenafil vs placebo, Outcome 2 Endpoint Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Sildenafil vs placebo, Outcome 3 Endpoint Clinical Global Impression - Sexual Function.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Sildenafil vs placebo, Outcome 4 Clinical Global Impression -Sexual Function not "much/very much improved" by endpoint.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Sildenafil vs placebo, Outcome 5 Endpoint Arizona Sexual Experience Scale (ASEX) total scores.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Sildenafil vs placebo, Outcome 6 Males: endpoint Arizona Sexual Experience Scale scores.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Sildenafil vs placebo, Outcome 7 Endpoint MGH-Sexual Functioning Questionnaire scores.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Sildenafil vs placebo, Outcome 8 Sexual dysfunction defined by Arizona Sexual Experience Scale at trial endpoint.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Sildenafil vs placebo, Outcome 9 Dropouts.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Sildenafil vs placebo, Outcome 10 Endpoint Hamilton Rating Scale for Depression score.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Sildenafil vs placebo, Outcome 11 Loss of remission: Hamilton Rating Scale for Depression score > 9.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Sildenafil vs placebo, Outcome 12 Global Efficacy Questionnaire (questions 1 & 2).
[Analysis 1.13]
Analysis 1.13. Comparison 1 Sildenafil vs placebo, Outcome 13 Global efficacy questionnaire (question 3).
[Analysis 1.14]
Analysis 1.14. Comparison 1 Sildenafil vs placebo, Outcome 14 Endpoint Sexual Function Questionnaire (SFQ).
[Analysis 1.15]
Analysis 1.15. Comparison 1 Sildenafil vs placebo, Outcome 15 UNM Sexual Function Inventory.
[Analysis 1.16]
Analysis 1.16. Comparison 1 Sildenafil vs placebo, Outcome 16 Females: endpoint Arizona Sexual Experience Scale scores.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Tadalafil vs placebo, Outcome 1 Global Assessment Questions.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Tadalafil vs placebo, Outcome 2 Endpoint Sexual Encounter Profile (SEP).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Tadalafil vs placebo, Outcome 3 Dropouts.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Bupropion vs placebo, Outcome 1 Endpoint scale total scores.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Bupropion vs placebo, Outcome 2 Response (as defined by study).
[Analysis 3.3]
Analysis 3.3. Comparison 3 Bupropion vs placebo, Outcome 3 Endpoint International Index of Erectile Function (IIEF).
[Analysis 3.4]
Analysis 3.4. Comparison 3 Bupropion vs placebo, Outcome 4 Endpoint Female Sexual Function Index score.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Bupropion vs placebo, Outcome 5 Endpoint Changes in Sexual Functioning Questionnaire score.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Bupropion vs placebo, Outcome 6 Dropouts.
[Analysis 3.7]
Analysis 3.7. Comparison 3 Bupropion vs placebo, Outcome 7 Endpoint Hamilton Rating Scale for Depression score.
[Analysis 3.8]
Analysis 3.8. Comparison 3 Bupropion vs placebo, Outcome 8 Endpoint Clinical Global Impression (CGI - SF).
[Analysis 3.9]
Analysis 3.9. Comparison 3 Bupropion vs placebo, Outcome 9 Endpoint ASEX.
[Analysis 3.10]
Analysis 3.10. Comparison 3 Bupropion vs placebo, Outcome 10 Endpoint EDITS (participant).
[Analysis 3.11]
Analysis 3.11. Comparison 3 Bupropion vs placebo, Outcome 11 Endpoint EDITS (partner).
[Analysis 4.1]
Analysis 4.1. Comparison 4 Nefazodone vs sertraline, Outcome 1 Re-emergence of antidepressant-induced sexual dysfunction (physician rated).
[Analysis 4.2]
Analysis 4.2. Comparison 4 Nefazodone vs sertraline, Outcome 2 Overall degree of sexual satisfaction (participant rated).
[Analysis 4.3]
Analysis 4.3. Comparison 4 Nefazodone vs sertraline, Outcome 3 Dropouts.
[Analysis 4.4]
Analysis 4.4. Comparison 4 Nefazodone vs sertraline, Outcome 4 Hamilton Rating Scale for Depression score.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Ginkgo biloba vs placebo, Outcome 1 Endpoint sexual function ratings (investigator questionnaire).
[Analysis 5.2]
Analysis 5.2. Comparison 5 Ginkgo biloba vs placebo, Outcome 2 Sexual Dysfunction Scale (investigator developed).
[Analysis 5.3]
Analysis 5.3. Comparison 5 Ginkgo biloba vs placebo, Outcome 3 Dropouts.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Granisetron vs placebo, Outcome 1 Change from baseline on Sexual Side Effects Scale (SSES) total score.
[Analysis 6.2]
Analysis 6.2. Comparison 6 Granisetron vs placebo, Outcome 2 Endpoint Feiger Sexual Function and Satisfaction Questionnaire score.
[Analysis 6.3]
Analysis 6.3. Comparison 6 Granisetron vs placebo, Outcome 3 Endpoint Arizona Sexual Experience Scale (ASEX) score.
[Analysis 6.4]
Analysis 6.4. Comparison 6 Granisetron vs placebo, Outcome 4 Dropouts.
[Analysis 6.5]
Analysis 6.5. Comparison 6 Granisetron vs placebo, Outcome 5 Recurrence of mood symptoms.
[Analysis 7.1]
Analysis 7.1. Comparison 7 VML-670 vs placebo, Outcome 1 Absence of sexual dysfunction at end point.
[Analysis 7.2]
Analysis 7.2. Comparison 7 VML-670 vs placebo, Outcome 2 'Improved' or 'much improved' on Clinical Global Impression.
[Analysis 7.3]
Analysis 7.3. Comparison 7 VML-670 vs placebo, Outcome 3 Change in Arizona Sexual Experiences Scale (ASEX) item scores.
[Analysis 7.4]
Analysis 7.4. Comparison 7 VML-670 vs placebo, Outcome 4 Dropouts.
[Analysis 8.1]
Analysis 8.1. Comparison 8 Buspirone vs placebo, Outcome 1 Change in patient-rated visual analogue scales.
[Analysis 8.2]
Analysis 8.2. Comparison 8 Buspirone vs placebo, Outcome 2 Dropouts.
[Analysis 9.1]
Analysis 9.1. Comparison 9 Bethanecol vs placebo, Outcome 1 Visual analogue scale of orgasmic function - best score achieved.
[Analysis 10.1]
Analysis 10.1. Comparison 10 Olanzapine vs placebo, Outcome 1 Change in patient rated assessment of sexual function.
[Analysis 10.2]
Analysis 10.2. Comparison 10 Olanzapine vs placebo, Outcome 2 Change in diary ratings (visual analogue scales).
[Analysis 10.3]
Analysis 10.3. Comparison 10 Olanzapine vs placebo, Outcome 3 Dropouts due to adverse effects.
[Analysis 11.1]
Analysis 11.1. Comparison 11 Mirtazapine vs placebo, Outcome 1 Change in patient rated assessment of sexual function.
[Analysis 11.2]
Analysis 11.2. Comparison 11 Mirtazapine vs placebo, Outcome 2 Change in diary ratings (visual analogue scales).
[Analysis 11.3]
Analysis 11.3. Comparison 11 Mirtazapine vs placebo, Outcome 3 Endpoint modified Kinsey Structured Interview.
[Analysis 11.4]
Analysis 11.4. Comparison 11 Mirtazapine vs placebo, Outcome 4 Dropouts.
[Analysis 12.1]
Analysis 12.1. Comparison 12 Yohimbine vs placebo, Outcome 1 Change in patient rated assessment of sexual function.
[Analysis 12.2]
Analysis 12.2. Comparison 12 Yohimbine vs placebo, Outcome 2 Change in diary ratings (visual analogue scales).
[Analysis 12.3]
Analysis 12.3. Comparison 12 Yohimbine vs placebo, Outcome 3 Dropouts.
[Analysis 13.1]
Analysis 13.1. Comparison 13 Amantadine vs placebo, Outcome 1 Change in patient-rated visual analogue scales.
[Analysis 13.2]
Analysis 13.2. Comparison 13 Amantadine vs placebo, Outcome 2 Dropouts.
[Analysis 14.1]
Analysis 14.1. Comparison 14 ephedrine vs placebo, Outcome 1 Endpoint Brief Index of Sexual Functioning for Women (BISF-W).
[Analysis 15.1]
Analysis 15.1. Comparison 15 Maca root: high vs low dose, Outcome 1 Endpoint Arizona Sexual Experiences Scale (ASEX) score.
[Analysis 15.2]
Analysis 15.2. Comparison 15 Maca root: high vs low dose, Outcome 2 Endpoint MGH-SFQ.
[Analysis 15.3]
Analysis 15.3. Comparison 15 Maca root: high vs low dose, Outcome 3 Dropouts.
[Analysis 15.4]
Analysis 15.4. Comparison 15 Maca root: high vs low dose, Outcome 4 Endpoint ratings of psychiatric symptoms.