Evaluation of sexual functioning in depressed outpatients: A double-blind comparison of sustained-release bupropion and sertraline treatment

Sexual dysfunction is a frequently reported side effect of many antidepress ants, including serotonin reuptake inhibitors. Bupropion, an antidepressant of the aminoketone class, is relatively free of adverse sexual effects. In a randomized, double-blind, multicenter trial, sustained-release bupropion (bupropion SR) and sertraline, a selective serotonin reuptake inhibitor, m ere found to be similarly efficacious in the treatment of outpatients with moderate to severe depression. This report describes the results of a doubl e-blind comparison of the sexual side effect profiles of bupropion SE and s ertraline. Two hundred forty-eight patients who had received a diagnosis of moderate to severe major depression mere randomly assigned to receive trea tment with bupropion SR (100-300 mg/day) or sertraline (50-200 mg/day) for 16 weeks. Eligible patients were required to be in a stable relationship an d to have normal sexual functioning. Sexual functioning was assessed by the investigator at each clinic visit using investigator-rated structured inte rviews, A significantly greater percentage of sertraline-treated patients ( 63% and 41% of men and women, respectively) developed sexual dysfunction co mpared with bupropion SR-treated patients (15% and 7%, respectively). Sexua l dysfunction mas noted as early as day 7 in sertraline-treated patients at a dose of 50 mg/day and persisted until the end of the 16-week treatment p hase, Four patients, ail of whom mere treated with sertraline, discontinued from the study prematurely because of sexual dysfunction. Given the simila r efficacy of the two drugs in treating depression, bupropion SR may be a m ore appropriate antidepressant choice than sertraline in patients for whom sexual dysfunction is a concern.