Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors

To evaluate the possible influence of buspirone on sexual dysfunction in de pressed patients treated with a selective serotonin reuptake inhibitor (SSR I), we analyzed data hom a placebo-controlled trial designed to explore the efficacy of buspirone as add-on treatment for patients not responding to a n SSRI alone. At baseline, all patients met the criteria for a major depres sive episode according to DSM-IV and had received citalopram or paroxetine during a minimum of 4 weeks without responding to the treatment. Buspirone (flexible dosage, 20-60 mg/day) or placebo was added to the SSRI for 4 week s; the mean daily dose of buspirone at endpoint was 48.5 mg (SD = 1.0). Sex ual dysfunction was evaluated using a structured interview. Before starting medication with buspirone or placebo, 40% (47 of 117) reported at least on e kind of sexual dysfunction (decreased libido, ejaculatory dysfunction, or gasmic dysfunction). During the 4 weeks of treatment, approximately 58% of subjects treated with buspirone reported an improvement with respect to sex ual function; in the placebo group, the response rate was 30%;. The differe nce between placebo and active drug treatment was more pronounced in women than in men. The response was obvious during the first week, with no furthe r improvement during the course of the study. It is suggested that the effe ct of buspirone on sexual dysfunction is a result of a reversal of SSRI-ind uced sexual side effects rather than of an anti-depressant effect of the dr ug.