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Doctors Don’t Ask, Patients Don’t Tell: Some Surprising Side Effects of Treating Depression

In any given year, up to 14 million adults in the U.S. are affected by major depressive disorder (MDD), commonly referred to as depression. Ten percent of women and 4 percent of men aged 18 and older now take antidepressants for depression. Surprisingly, however, many patients may not be aware that the medicine they are taking may cause sexual problems. This may cause some confusion because sexual problems can also be a symptom of depression.

In a recent survey, conducted by International Communications Research on behalf of GlaxoSmith Kline, of 1,003 men and women prescribed antidepressant medication to treat depression, sexual problems were cited by about half (48 percent) of respondents as the most commonly experienced side effect of antidepressants.

“Many people don’t realize that their sexual problems can be caused by major depressive disorder itself or by some of the treatments,” said Adam Keller Ashton, M.D., clinical professor of psychiatry with the State University of New York at Buffalo. According to the survey, a lack of sex drive was the most notable sexual problem experienced (77 percent), followed by the inability to have an orgasm (56 percent).

Both depression and sexual problems can be difficult topics to discuss with a doctor. In one study, only 20 percent of patients proactively reported antidepressant-related sexual problems to their health care provider. In contrast, 59 percent of patients reported sexual problems when directly asked about it.

Doctors may also not remember to tell patients about this potential side effect. In one study, only 16 percent of patients said their doctor told them about sexual problems related to antidepressant treatment, yet 69 percent of doctors said they normally mention this side effect.

“Sexual dysfunction associated with antidepressants does occur and can be a bothersome side effect for patients taking an antidepressant,” said Ashton. “No one antidepressant is right for everyone, yet there are plenty of options to meet patients’ needs, which is why it’s critical for doctors to discuss and patients to ask about side effects of any medication prescribed.”

Some antidepressants that affect the neurotransmitter serotonin seem to have higher incidence of sexual problems compared to those that do not. In fact, several studies have shown that the incidence of sexual problems reported with the use of serotonergic antidepressants can range from 34 to 67 percent.

“Wellbutrin XL® (bupropion HCl extended-release tablets) is a norepinephrine and dopamine reuptake inhibitor, which has no significant impact on serotonin and has a low risk of sexual side effects,” said Ashton.

Pepper Schwartz, Ph.D., professor of sociology at the University of Washington, Seattle, agrees that patients should educate themselves about depression, its treatment and potential side effects of treatment. Being armed with this information, patients can learn to become more comfortable having this discussion with their physician. “A good working relationship with a doctor is important to help get the care you need,” said Schwartz, “and it relies on good communication.”

At left is a list of tips for talking to your doctor about depression and sexual problems.

Important Safety Information

Wellbutrin XL is not for everyone. There is a risk of seizure when taking Wellbutrin XL, so people who have had a seizure or eating disorder, or have abruptly stopped using alcohol or sedatives, should not take Wellbutrin XL. People should not use Wellbutrin XL with monoamine oxidase inhibitors (MAOIs) or medicines that contain bupropion. When used with a nicotine patch or alone, there is a risk of increased blood pressure, sometimes severe. To reduce risk of serious side effects, people should tell their doctor if they have liver or kidney problems. Other side effects may include weight loss, dry mouth, nausea, difficulty sleeping, dizziness or sore throat.

Wellbutrin XL is approved only for adults 18 years old and over. In some children and teens, anti-depressants increase suicidal thoughts or actions.

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