Psychostimulants apparently reverse sexual dysfunction secondary to selective serotonin re-uptake inhibitors

Bartlik, Barbara; Kaplan, Peter M.; Kaplan, Helen Singer

doi:10.1080/00926239508414646

Cited by 67 publications

(22 citation statements)

References 9 publications

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“…Moreover, flibanserin, which enhances NE and DA while reducing 5-HT (Borsini et al, 2002), increased sexual desire in women with hypoactive sexual desire (Katz et al, 2013). Finally, dextroamphetamine and methylphenidate have been reported to reverse the sexually impairing effects of 5-HT transporter blockers and to even enhance sexual arousal and function in female and male patients with depression (Bartlik et al, 1995).…”

Section: Discussionmentioning

confidence: 98%

Effects of methylphenidate and MDMA on appraisal of erotic stimuli and intimate relationships

Schmid

Hysek

Preller

et al. 2015

European Neuropsychopharmacology

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Methylphenidate mainly enhances dopamine neurotransmission whereas 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") mainly enhances serotonin neurotransmission. However, both drugs also induce a weaker increase of cerebral noradrenaline exerting sympathomimetic properties. Dopaminergic psychostimulants are reported to increase sexual drive, while serotonergic drugs typically impair sexual arousal and functions. Additionally, serotonin has also been shown to modulate cognitive perception of romantic relationships. Whether methylphenidate or MDMA alter sexual arousal or cognitive appraisal of intimate relationships is not known. Thus, we evaluated effects of methylphenidate (40mg) and MDMA (75mg) on subjective sexual arousal by viewing erotic pictures and on perception of romantic relationships of unknown couples in a double-blind, randomized, placebo-controlled, crossover study in 30 healthy adults. Methylphenidate, but not MDMA, increased ratings of sexual arousal for explicit sexual stimuli. The participants also sought to increase the presentation time of implicit sexual stimuli by button press after methylphenidate treatment compared with placebo. Plasma levels of testosterone, estrogen, and progesterone were not associated with sexual arousal ratings. Neither MDMA nor methylphenidate altered appraisal of romantic relationships of others. The findings indicate that pharmacological stimulation of dopaminergic but not of serotonergic neurotransmission enhances sexual drive. Whether sexual perception is altered in subjects misusing methylphenidate e.g., for cognitive enhancement or as treatment for attention deficit hyperactivity disorder is of high interest and warrants further investigation.

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Section: Discussionmentioning

confidence: 98%

Effects of methylphenidate and MDMA on appraisal of erotic stimuli and intimate relationships

Schmid

Hysek

Preller

et al. 2015

European Neuropsychopharmacology

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“…Finally, although psychostimulants on a p.r.n. basis improved sexual functioning in 5 patients on SSRIs [19], their potential for abuse has limited the frequency of use of this approach.…”

Section: Introductionmentioning

confidence: 99%

An Open Trial of Oral Sildenafilin Antidepressant-Induced Sexual Dysfunction

Fava

Rankin

Alpert

et al. 1998

Psychother Psychosom

115

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Background: Sildenafil is a selective inhibitor of cyclic GMP-specific phosphodiesterase type 5 that has been associated with greater improvement of erectile function compared to placebo among men with erectile dysfunction. The goal of our study was to evaluate its efficacy in a small sample of outpatients with antidepressant-induced sexual dysfunction. Methods: We studied the first 14 depressed outpatients (9 men and 5 women; mean age: 46.4 ± 8.4) who were consecutively treated with oral sildenafil. Twelve of the 14 patients were treated with an SSRI and 2 with mirtazapine. All patients were prescribed oral sildenafil tablets at the initial dose of 50 mg q.d. p.r.n., with the possibility of increasing the dose to 100 mg q.d. p.r.n., if clinically indicated. We administered a sexual functioning questionnaire derived from the Guided Interview Questionnaire for females and males and from the Arizona Sexual Experience Scale to all patients before and after at least 4 weeks of treatment with oral sildenafil. The mean sildenafil dose in our 14 patients was 57 ± 18 mg/day. Results: All 14 subjects completed the follow-up assessments and no subjects discontinued the drug prematurely. We observed statistically significant improvements in all domains of sexual functioning, including libido, arousal, orgasm, sexual satisfaction, and (in males only) erectile function, with a 69% rate of patients reporting themselves as much or very much improved. Oral sildenafil treatment appeared to be very well tolerated, with only 1 out of 14 (7%) patients reporting an adverse event (hot flashes). Conclusions: Our findings of statistically significant improvements in all domains of sexual functioning in a sample of 14 men and women with antidepressant-induced sexual dysfunction suggest that this agent may represent an efficacious approach to this population.

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“…Adding a concomitant selective serotonin reuptake inhibitor (SSRI) instead of cessation of the stimulant might be a treatment option. Bartlik and colleagues showed that MPH apparently reversed sexual dysfunction secondary to SSRIs [Bartlik et al 1995]. If we consider the opposite, it would be a reasonable option.…”

Section: Discussionmentioning

confidence: 99%