Bupropion as an antidote for serotonin reuptake inhibitor-induced sexual dysfunction

Background: Serotonin reuptake inhibiting antidepressants (SRIs) are reported to cause sexual dysfunctions, including reduction in desire, arousal, and orgasm. This study evaluates the efficacy of bupropion in ameliorating sexual dysfunctions in patients receiving SRIs. Method: Forty-seven patients in an outpatient psychiatric practice who complained of SRI-induced sexual dysfunction accepted a trial of bupropion as an adjunct to their SRI, either as a p.r.n. or as a fixed-dose scheduled medicine. Patients received 75 mg or 150 mg of bupropion 1 to 2 hours before sexual activity. If this was insufficient to reduce their complaints, dose was increased gradually to 75 mg t.i.d. and sustained for 2 weeks. This regimen was then continued if successful. Results: Bupropion successfully reversed a variety of sexual dysfunctions caused by SRIs in 31 (66%) of 47 patients. Fifty-two (69%) of 75 sexual complaints improved with bupropion treatment. The p.r.n. use of bupropion assisted 18 (38%) of 47 patients. Side effects of anxiety and tremor led to discontinuation of bupropion in 7 (15%) of 47 patients. Otherwise, bupropion was well tolerated. Conclusion: Bupropion administration may be a safe and effective method of treating SRI-induced sexual dysfunction. Placebo-controlled, double-blind studies are needed.