A Placebo-Controlled, Randomized, Double-Blind Study of Adjunctive Bupropion Sustained Release in the Treatment of SSRI-Induced Sexual Dysfunction

Charles DeBattista, M.D.; Brent Solvason, M.D.; Jennifer Poirier, Ph.D.; Ellen Kendrick, B.A.; and Emily Loraas, B.A.

Background: Sexual side effects are among the common reasons patients discontinue selective serotonin reuptake inhibitors (SSRIs). While many antidotes have been proposed, few have been subjected to double-blind trials. Some evidence has suggested that bupropion may be an effective antidote for SSRI-induced sexual dysfunction. In this double-blind trial, the efficacy of a standard dose of bupropion sustained release (SR) is evaluated in the treatment of SSRI-induced sexual dysfunction.

Method: Patients with a history of SSRI-induced sexual side effects were randomly assigned to adjunctive treatment with either bupropion SR 150 mg daily or placebo for 6 weeks. Assessments of sexual function and interest included the Arizona Sexual Experiences Scale (ASEX), Brief Index of Sexual Functioning, and a 10-point visual analogue scale. Efficacy was defined as a 50% improvement on the ASEX at the end of 6 weeks. Data were collected from January 1999 to March 2001.

Results: Forty-one patients entered the study and completed the 6-week trial. No significant differences were seen between placebo and bupropion SR on the ASEX or on any measure of sexual functioning at the end of the trial.

Conclusion: A fixed dose of 150 mg/day of bupropion SR taken in the morning does not appear to be effective in the treatment of SSRI-induced sexual dysfunction. Additional trials will be required to define what role, if any, bupropion might have in the treatment of SSRI-induced sexual side effects.

(J Clin Psychiatry 2005;66:844-848)

Received June 4, 2004; accepted Dec. 7, 2004. From the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif.

This study was supported by a grant from GlaxoSmithKline.

Dr. DeBattista has served as a consultant to Wyeth, Eli Lilly, Bristol-Myers Squibb, and Corcept Therapeutics; has received grant/research support from the National Institute of Mental Health, Pratzker Foundation, Cephalon, Eli Lilly, Cyberonics, Neuronetics, Somerset, and Wyeth; has participated in speakers or advisory boards for GlaxoSmithKline, Wyeth, Eli Lilly, Bristol-Myers Squibb, Pfizer, Cephalon, Abbott, and Corcept Therapeutics; and is a stockholder in Corcept Therapeutics. Drs. Solvason and Poirier and Mss. Kendrick and Loraas have received grant/research support from GlaxoSmithKline.

Corresponding author and reprints: Charles DeBattista, M.D., Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd., Stanford University School of Medicine, Stanford, CA 94305 (e-mail: debattista@stanford.edu).