Treatments of Sexual Dysfunction in Opioid Substitution Therapy Patients: A Systematic Review and Meta-Analysis

Abstract

Sexual dysfunction is a common condition in the opioid substitution therapy (OST) population. We aimed to determine the efficacy and safety of treatment for sexual dysfunction in the OST population. We searched for interventional studies from Medline, PubMed, and Scopus. Three independent authors conducted a risk-of-bias assessment (RoB 2). A total of seven studies (five randomized-controlled trials, two quasi-experimental), including 473 patients with sexual dysfunction, were identified. Among these, three bupropion (n=207), one trazodone (n=75), two rosa Damascena (n=100), and one ginseng (n=91) studies had reported significantly improve various sexual functioning domains in both genders. In a meta-analysis, bupropion significantly increased male sexual function with standardized mean difference of 0.53; 95% confidence interval of 0.19-0.88; P < 0.01; I 2 =0. The adverse effects were minor for all agents, and no significant difference between treatment and placebo groups in randomized-controlled trials. These agents have a promising future as therapy for sexual dysfunction in the OST population. However, given the limited sample size and number of studies, further studies should be conducted to confirm the use of these agents.

A phase 1b study to investigate the potential interactions between ASP8062 and buprenorphine/naloxone in patients with opioid use disorder

“…These trends have been exacerbated by the COVID-19 pandemic (National Institute on Drug Abuse, 2021). Further, opioid use can lead to medical consequences such as: the spread of viral infectious diseases (National Institute on Drug Abuse, 2020); psychiatric consequences, such as increased risk of depression or anxiety (Rosoff et al, 2021; Scherrer et al, 2014); sexual dysfunction (Ramli et al, 2021) and sleep disorders (Rosen et al, 2019); serious interpersonal and family problems, such as divorce (Edwards et al, 2018); financial consequences, such as decreased participation in the labor market (Bockerman et al, 2021; Organisation for Economic Co-operartion and Development, 2018); and legal issues (National Academies of Sciences, Engineering, and Medicine, 2017; Winkelman et al, 2018). Despite a 38% reduction in opioid prescriptions, the number of opioid-related deaths has continued to rise, increasing by 300% over the past decade, suggesting that recent attempts to curb OUD have not been successful and new approaches are warranted (Kharasch et al, 2022).…”