Bupropion as an Antidote for Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction

Background: Serotonin reuptake inhibitingantidepressants (SRIs) are reported to cause sexual dysfunctions,including reduction in desire, arousal, and orgasm. This studyevaluates the efficacy of bupropion in ameliorating sexualdysfunctions in patients receiving SRIs.

Method: Forty-seven patients in an outpatientpsychiatric practice who complained of SRI-induced sexualdysfunction accepted a trial of bupropion as an adjunct to theirSRI, either as a p.r.n. or as a fixed-dose scheduled medicine.Patients received 75 mg or 150 mg of bupropion 1 to 2 hoursbefore sexual activity. If this was insufficient to reduce theircomplaints, dose was increased gradually to 75 mg t.i.d. andsustained for 2 weeks. This regimen was then continued ifsuccessful.

Results: Bupropion successfully reversed avariety of sexual dysfunctions caused by SRIs in 31 (66%) of 47patients. Fifty-two (69%) of 75 sexual complaints improved withbupropion treatment. The p.r.n. use of bupropion assisted 18(38%) of 47 patients. Side effects of anxiety and tremor led todiscontinuation of bupropion in 7 (15%) of 47 patients.Otherwise, bupropion was well tolerated.

Conclusion: Bupropion administration may be asafe and effective method of treating SRI-induced sexualdysfunction. Placebo-controlled, double-blind studies are needed.