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Keywords:

  • Gepirone-ER;
  • HSDD;
  • Hypoactive Sexual Desire Disorder;
  • 5-HT1A Agonist;
  • DSM-IV Diagnoses of Sexual Disorders;
  • Treatment of Depression and Sexual Dysfunction

ABSTRACT

Introduction.  Eleven hundred eighty-four depressed women were entered into five short-term (8 weeks) studies of gepirone-extended release (ER) vs. placebo for treatment of major depressive disorder (MDD) (134001, 134002, and 134017), or atypical depressive disorder (ADD) (134004 and 134006). The effect of depression on sexual function was examined prior to treatment.

Aim.  To determine the effect of depression on the prevalence of Diagnostic and Statistical Manual Fourth Edition (DSM-IV) sexual dysfunction diagnoses and the Derogatis Inventory of Sexual Function (DISF) total score and domain scores and to measure the effect of severity of depression.

Main Outcome Measures.  Hamilton Depression Rating Scale (HAMD-17), DSM-IV diagnoses, and DISF total and domain scores.

Methods.  DSM-IV diagnoses—hypoactive sexual desire disorder (HSDD), sexual aversion disorder (SAD), female arousal disorder (FAD), and female orgasmic disorder (FOD)—were made by a trained psychiatrist. The HAMD-17 measured antidepressant efficacy. The DISF or its self-report version measured sexual function. To access the effect of severity of depression, baseline HAMD-17 scores were stratified as mild (<18), moderate (19–22), severe (23–25), or extreme (26–33). All measures were taken at baseline.

Results.  In this depressed female population, prevalence rates were HSDD 17.7%, SAD 3.4%, FAD 5.8%, and FOD 7.7%. These rates for females are within the reported normal (nondepressed) values. However, DISF scores are one or more standard deviations below population norms for total score. DISF domains are not equally affected: orgasm is most impaired, while sexual desire and sexual arousal are somewhat preserved. Higher HAMD scores result in lower DISF scores (greater sexual dysfunction).

Conclusions.  In women, depression affects DISF scores more than DSM-IV diagnoses for sexual dysfunction. With increasing severity of depression (increased HAMD scores), sexual dysfunction becomes greater (lower DISF scores). For equal HAMD scores, DISF scores for MDD and ADD are the same. Fabre LF and Smith LC. The effect of major depression on sexual function in women. J Sex Med 2012;9:231–239.