Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study
Treatment-emergent sexual dysfunction (TESD) is one of the most frequent and persistent adverse effects of antidepressant medication. Sexual dysfunction (SD) secondary to SSRIs occurs in >60% of sexually active patients and >80% of healthy volunteers, with this causing treatment discontinuatio...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/2/546 |
| _version_ | 1797339705857015808 |
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| author | Angel L. Montejo Froilán Sánchez-Sánchez Rubén De Alarcón Juan Matías Benjamin Cortés Claudia Matos Tomás Martín-Pinto Peñitas Ríos Nerea González-García José María Acosta |
| author_facet | Angel L. Montejo Froilán Sánchez-Sánchez Rubén De Alarcón Juan Matías Benjamin Cortés Claudia Matos Tomás Martín-Pinto Peñitas Ríos Nerea González-García José María Acosta |
| author_sort | Angel L. Montejo |
| collection | DOAJ |
| description | Treatment-emergent sexual dysfunction (TESD) is one of the most frequent and persistent adverse effects of antidepressant medication. Sexual dysfunction (SD) secondary to SSRIs occurs in >60% of sexually active patients and >80% of healthy volunteers, with this causing treatment discontinuation in >35% of patients. However, this factor is rarely addressed in routine examinations, and only 15–30% of these events are spontaneously reported. A strategy of switching to a different non-serotonergic antidepressant could involve a risk of relapse or clinical worsening due to a lack of serotonergic activity. Vortioxetine appears to have less impact on sexual function due to its multimodal mechanism of action. No studies have been published on the effectiveness of switching to vortioxetine in patients with poorly tolerated long-term antidepressant-related SD in naturalistic settings. Study objectives: To determine the effectiveness of switching to vortioxetine due to SD in a routine clinical practice setting. Methodology: observational pragmatic and naturalistic study to determine the effectiveness of the switch to vortioxetine (mean dosage 13.11 ± 4.03) in 74 patients aged 43.1 ± 12.65 (54% males) at risk of discontinuing treatment due to sexual dysfunction. The PRSexDQ*- SALSEX scale (<b>*</b> Psychotropic-Related Sexual Dysfunction Questionnaire) was applied at two moments: baseline visit and after 3 months of follow-up. Results: global Sexual Dysfunction (SD) measured with the SALSEX scale decreased significantly between the baseline visit (10.32; SD 2.73) and the follow-up visit (3.78; SD 3.68), <i>p</i> < 0.001. There was a significant improvement (<i>p</i> < 0.001) at the endpoint including decreased libido, delay of orgasm, anorgasmia and arousal difficulties in both sexes. After switching to vortioxetine, 83.81% of patients experienced an improvement in sexual function (43.2% felt greatly improved). Most patients (83.3%) who switched to vortioxetine continued treatment after the follow-up visit. A total of 58.1% of patients showed an improvement in depressive symptoms from the baseline visit. Conclusion: switching to vortioxetine is an effective and reliable strategy to treat patients with poorly tolerated previous antidepressant-related sexual dysfunction in real-life clinical settings. |
| first_indexed | 2024-03-08T09:52:15Z |
| format | Article |
| id | doaj.art-c1cad64e21f04e1f8786b7592c7d2db9 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T09:52:15Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c1cad64e21f04e1f8786b7592c7d2db92024-01-29T14:02:53ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113254610.3390/jcm13020546Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life StudyAngel L. Montejo0Froilán Sánchez-Sánchez1Rubén De Alarcón2Juan Matías3Benjamin Cortés4Claudia Matos5Tomás Martín-Pinto6Peñitas Ríos7Nerea González-García8José María Acosta9Nursing School, University of Salamanca, Av. Donantes de Sangre SN, 37004 Salamanca, SpainCentro de Salud Xàtiva, Xàtiva, 46800 Valencia, SpainServicio de Psiquiatría, Hospital Universitario de Salamanca, 37007 Salamanca, SpainServicio de Psiquiatría, Hospital Universitario de Salamanca, 37007 Salamanca, SpainServicio de Psiquiatría, Hospital Universitario de Salamanca, 37007 Salamanca, SpainServicio de Psiquiatría, Hospital Universitario de Salamanca, 37007 Salamanca, SpainServicio de Psiquiatría, Hospital Universitario de Salamanca, 37007 Salamanca, SpainHospital Universitario Cáceres, 10004 Cáceres, SpainStatistical Department, University of Salamanca, 37004 Salamanca, SpainInstituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente SN, 37007 Salamanca, SpainTreatment-emergent sexual dysfunction (TESD) is one of the most frequent and persistent adverse effects of antidepressant medication. Sexual dysfunction (SD) secondary to SSRIs occurs in >60% of sexually active patients and >80% of healthy volunteers, with this causing treatment discontinuation in >35% of patients. However, this factor is rarely addressed in routine examinations, and only 15–30% of these events are spontaneously reported. A strategy of switching to a different non-serotonergic antidepressant could involve a risk of relapse or clinical worsening due to a lack of serotonergic activity. Vortioxetine appears to have less impact on sexual function due to its multimodal mechanism of action. No studies have been published on the effectiveness of switching to vortioxetine in patients with poorly tolerated long-term antidepressant-related SD in naturalistic settings. Study objectives: To determine the effectiveness of switching to vortioxetine due to SD in a routine clinical practice setting. Methodology: observational pragmatic and naturalistic study to determine the effectiveness of the switch to vortioxetine (mean dosage 13.11 ± 4.03) in 74 patients aged 43.1 ± 12.65 (54% males) at risk of discontinuing treatment due to sexual dysfunction. The PRSexDQ*- SALSEX scale (<b>*</b> Psychotropic-Related Sexual Dysfunction Questionnaire) was applied at two moments: baseline visit and after 3 months of follow-up. Results: global Sexual Dysfunction (SD) measured with the SALSEX scale decreased significantly between the baseline visit (10.32; SD 2.73) and the follow-up visit (3.78; SD 3.68), <i>p</i> < 0.001. There was a significant improvement (<i>p</i> < 0.001) at the endpoint including decreased libido, delay of orgasm, anorgasmia and arousal difficulties in both sexes. After switching to vortioxetine, 83.81% of patients experienced an improvement in sexual function (43.2% felt greatly improved). Most patients (83.3%) who switched to vortioxetine continued treatment after the follow-up visit. A total of 58.1% of patients showed an improvement in depressive symptoms from the baseline visit. Conclusion: switching to vortioxetine is an effective and reliable strategy to treat patients with poorly tolerated previous antidepressant-related sexual dysfunction in real-life clinical settings.https://www.mdpi.com/2077-0383/13/2/546sexual dysfunctionantidepressantvortioxetinedepressionsexuality |
| spellingShingle | Angel L. Montejo Froilán Sánchez-Sánchez Rubén De Alarcón Juan Matías Benjamin Cortés Claudia Matos Tomás Martín-Pinto Peñitas Ríos Nerea González-García José María Acosta Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study Journal of Clinical Medicine sexual dysfunction antidepressant vortioxetine depression sexuality |
| title | Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study |
| title_full | Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study |
| title_fullStr | Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study |
| title_full_unstemmed | Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study |
| title_short | Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study |
| title_sort | switching to vortioxetine in patients with poorly tolerated antidepressant related sexual dysfunction in clinical practice a 3 month prospective real life study |
| topic | sexual dysfunction antidepressant vortioxetine depression sexuality |
| url | https://www.mdpi.com/2077-0383/13/2/546 |
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