Comparison of moclobemide with selective serotonin reuptake inhibitors (SSRIs) on sexual function in depressed adults

Objective: To compare the emergent sexual effects of moclobemide and select ive serotonin reuptake inhibitors (SSRIs) during acute and maintenance ther apy in routine practice. Method: 268 patients were evaluated for sexual fun ction at baseline, 6 weeks, 3 and 6 months of treatment using physician rat ings and self-rating questionnaires. Patients received moclobemide, an reve rsible monoamine oxidase A inhibitor (RIMA), or a SSRI (fluoxetine, fluvoxa mine, paroxetine, sertraline). Results: Baseline values were similar in all groups. Incidences of impairments of sexual functioning with treatment, wh ether clinically relevant or not, were 24.3% with moclobemide and 61.5% wit h SSRIs (physician ratings), with no significant tolerance to these effects . There was a suggestion of differences between the SSRIs in their specific dysfunctions they cause. SSRIs (21.6% of patients) had about ten times the moclobemide rate (1.9%) of sexual dysfunction reported as adverse events. Antidepressant efficacy was comparable between treatments. Conclusion: In p atients for whom sexual function is important or sexual dysfunction is pres ent, moclobemide should be considered a first line antidepressant. (C) 2000 Elsevier Science B.V. All rights reserved.