Female sexual dysfunction in patients treated with antidepressant-comparison between escitalopram and fluoxetine

Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD).

This study compares the prevalence of FSD between patients on escitalopram and fluoxetine. The risk factors for FSD were also examined.

A cross-sectional study involved 112 female depressed patients (56 each group) who were in remission (as defined in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] during the past 2 months with no significant signs or symptoms of the disturbance and Montgomery-Asberg Depression Rating Scale score of ≤10) from the psychiatric clinic in a university hospital. The rates of sexual dysfunction between the two groups were compared.

The subjects were interviewed by using Structured Clinical Interview for DSM-IV. Sexual dysfunction was assessed with the Malay Version of the Female Sexual Function Index.

The prevalence of FSD was 44.6% for all patients, 55.4% for the fluoxetine group, and 33.9% for the escitalopram group. Multivariate logistic regression analysis showed no significant difference in the risk of FSD between the two groups. Moderate to high dosing was the only significant associated factor for FSD (odds ratio = 4.89, 95% confidence interval = 1.94-12.33).

There was no significant difference in the risk of having FSD between patients treated with fluoxetine or escitalopram. Patients on higher dosage of antidepressant have higher risk of having FSD.