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Switching to Vortioxetine in Patients with Poor- Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study
Montejo, A.L.; Sánchez-Sánchez, F.; De Alarcón, R.; Matías, J.; Cortés, B.; Matos, C.; Martín-Pinto, T.; Ríos, P.; González-García, N.; Acosta, J.M. Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study. J. Clin. Med.2024, 13, 546.
Montejo, A.L.; Sánchez-Sánchez, F.; De Alarcón, R.; Matías, J.; Cortés, B.; Matos, C.; Martín-Pinto, T.; Ríos, P.; González-García, N.; Acosta, J.M. Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study. J. Clin. Med. 2024, 13, 546.
Montejo, A.L.; Sánchez-Sánchez, F.; De Alarcón, R.; Matías, J.; Cortés, B.; Matos, C.; Martín-Pinto, T.; Ríos, P.; González-García, N.; Acosta, J.M. Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study. J. Clin. Med.2024, 13, 546.
Montejo, A.L.; Sánchez-Sánchez, F.; De Alarcón, R.; Matías, J.; Cortés, B.; Matos, C.; Martín-Pinto, T.; Ríos, P.; González-García, N.; Acosta, J.M. Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study. J. Clin. Med. 2024, 13, 546.
Abstract
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 at 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 determinate 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 SALSEX Scale was applied at two moments: baseline visit and after 3 months of follow-up.
Results. The global Sexual Dysfunction (SD) measured with the SALSEX Scale, decreased significantly from baseline visit (10.32; SD 2.73) to follow-up visit (3.78; SD 3.68) p<0.001. There was a significant improvement ( p<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 sexual function improvement (43.2% felt greatly improved). Most patients (83.3%) who switched to vortioxetine continued treatment after the follow-up visit. 58.1% of patients showed an improvement in depressive symptoms from baseline visit. Conclusion. Switching to vortioxetine is an effective and reliable strategy to treat patients with poor tolerated previous antidepressant -related sexual dysfunction in the real-life clinical settings.
Keywords
Sexual Dysfunction; antidepressant; vortioxetine; depression; sexuality
Subject
Medicine and Pharmacology, Psychiatry and Mental Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.