Antidepressant-Induced Sexual Dysfunction Associated with Low Serum Free Testosterone SUMMARY

In the course of an evaluation for treatment of antidepressant induced sexual dysfunction (ASD) with a new agent, an unforeseen pattern emerged in the pre-treatment laboratory assessment. Free serum testosterone levels in both men and women study subjects were found to be below the normal ranges in 75 percent of subjects in this small study. There were no other consistent laboratory findings that could account for such a high percentage correlation. Further inquiries into the possible causes for decreased serum testosterone and its association with ASD seems warranted.

INTRODUCTION

Antidepressant induced sexual dysfunction (ASD) is a well recognized complication of treatment for mood and anxiety disorders (Gitlin 1997). Recent discoveries have helped to provide effective remedies for this significant obstacle to patient compliance and successful treatment outcome (Cohen 1997, Gitlin 1997, Bartlik 1995). However, no remedy is 100% effective. In addition, there is no fully satisfactory theory that explains the physiologic mechanisms responsible for the varied aspects of sexual dysfunction observed (Sussman 1998). In the course of an evaluation of treatment for ASD in a community office based research setting, a striking pattern emerged in the laboratory screening protocol. Free testosterone levels were found to be subnormal in 15 of 20 patients. No other consistent laboratory value nor physical examination finding could account for this observation. Causes for reduced free testosterone and its effect on sexual function are discussed with implications for future research and treatment strategies.