Improvement of selective serotonin reuptake inhibitor-induced sexual dysfunction without worsening of depressive symptom after switching to milnacipran.

摘要

To the Editor: Data suggest that 30percent to 60percent of patients under treatment with selective serotonin reuptake inhibitor (SSRIs) developed sexual dysfunction after initiation of these drugs, resulting in noncom-pliance with the treatment and disturbing patients' quality of life. At the present time, there are 3 serotonin-noradrenaline reuptake inhibitors available all over the world such as venlafaxine, duroxetine, and milnacipran with differing selectivity. Milnacipran blocks serotonin and noradrenaline with equal affinity, duroxetine has a 10-fold selectivity for serotonin, and venlafaxine has a 30-fold selectivity for serotonin at a therapeutic dose. Limited data have shown that venlafaxine produces the sexual dysfunction at the same rate as SSRIs, whereas duroxetine is less likely to cause it. Recently, Baldwin et al reported that milnacipran improves sexual function in parallel with improvement in other symptoms of depression. We describe here 3 cases with depression who improved SSRI-induced sexual dysfunction after switching to milnacipran.