Antidepressant use and treatment-emergent sexual dysfunction among patients with major depressive disorder: Results from an internet-based survey study

Background Antidepressants (ADs) are the mainstay of treatment for patients with major depressive disorder (MDD). Insufficient efficacy of ADs and tolerability issues/side effects, such as treatment-emergent sexual dysfunction (TESD), can lead to treatment discontinuation, symptom persistence, and diminished quality of life. Methods In this cross-sectional, internet-based survey, patients with MDD (aged 18–64 years) treated with ADs were categorized as continuers, switchers, or discontinuers based on their current oral AD use and any prior oral AD use in the last 12 months. The Carelon Research Healthcare Integrated Research Database was used as a sampling frame to identify survey-eligible adult patients. The survey fielding was conducted from May 29–October 1, 2020. Results Overall, 900 patients completed the survey (554 [62%] continuers, 298 [33%] switchers, and 48 [5%] discontinuers). The 852 patients currently using ADs reported current use of 1178 ADs (mean: 1.4 AD per patient), while the 294 respondents who either switched or discontinued ADs reported using a total of 534 ADs in the past 12 months (mean: 1.8 AD per patient). Provider recommendations, treatment efficacy, and medication side effects played an important role in AD continuation, switching, or discontinuation. Furthermore, 19% of respondents (continuers and switchers) with no history of sexual problems reported sexual problems with use of at least one current or prior AD. Limitations The discontinuer cohort was small with few respondents; thus, the between-group statistical comparisons were limited. Conclusions These findings highlight the importance of patient-physician shared decision-making for MDD management, including minimization of side effects.