A study out of the University of Virginia examining the prevalence of sexual dysfunction among antidepressant users reveals that while the drug classes known as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) were associated with a higher rate of sexual dysfunction, other antidepressants were associated with significantly lower rates, namely bupropion and nefazodone. These data suggest that sexual dysfunction may be related to serotonergic antidepressant therapy.
Wellbutrin, the brand name of bupropion, had the lowest overall rate of sexual dysfunction. It was associated with a rate of 22% of the overall population. The sustained release formulation fared almost as well with a rate of 25%. In contrast, the SSRIs (Prozac, Paxil, Zoloft and Celexa), venlafaxine (Effexor) and mirtazapine (Remeron) averaged about 40%. When subjects were removed who had other probable causes of sexual dysfunction, the results were even better. Wellbutrin's rate dropped to 7% with the other medications dropping to between 23-30%.
Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI). It is contraindicated in patients with a seizure disorder or those taking Zyban, which also contains bupropion. It is also contraindicated for those with a diagnosis of an eating disorder such as bulimia or anorexia and for those currently taking an MAOI.
The referenced study was performed by Dr. Anita H. Clayton, associate professor and vice chairman, Department of Psychiatric Medicine, University Virginia Health System and Dr. James Pradko, a primary care physician in New Baltimore, Mich. Results were presented on May 8, 2001 at the American Psychiatric Association annual meeting in New Orleans.
