A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction.

OBJECTIVE: This study reports the results of a placebo-controlled, double-blind comparison of bupropion sustained release (SR) as an antidote for sexual dysfunction versus placebo in 42 patients with selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction. Exploratory analyses of the association of testosterone and sexual functioning in women in the study were also performed. METHOD: Patients with DSM-IV major depression who experienced a therapeutic response to any SSRI and were experiencing medication-induced global or phase-specific sexual dysfunction, as measured by the Changes in Sexual Functioning Questionnaire (CSFQ), were randomly assigned to receive either bupropion SR 150 mg b.i.d. or placebo for 4 weeks in addition to the SSRI. Total testosterone levels were assessed at baseline and week 4. RESULTS: The difference in global sexual functioning, based on the total CSFQ score, was not statistically significant between the 2 groups at week 4, nor were differences in orgasm, desire/ interest as measured by sexual thoughts, or self-reported arousal. There was a statistically significant difference between the 2 groups at week 4 in desire as measured by self-report feelings of desire and frequency of sexual activity. Desire/ frequency showed a significantly greater improvement among those patients receiving bupropion SR compared with placebo (Wilk's F = 5.47, df = 1, p =.024). Frequency was significantly correlated to total testosterone level at baseline (r = 0.36, p =.027) and at week 4 (r = 0.41, p =.025). CONCLUSIONS: Bupropion SR, as an effective antidote to SSRI-induced sexual dysfunction, produced an increase in desire to engage in sexual activity and frequency of engaging in sexual activity compared with placebo. A larger study is needed to further investigate this finding.

A Study of Visual Hallucinations in Alzheimer's Disease.

The authors screened 98 patients with probable Alzheimer's disease for visual hallucinations. Each patient with visual hallucinations was matched by cognitive score to two patients without visual hallucinations and compared on variables including visual acuity and visual agnosia. Eighteen (18.4%) of the patients were found to have visual hallucinations. Variables significantly associated with hallucinations included older age, female sex, decreased visual acuity, and presence of visual agnosia. Although having a history of visual disorder approached statistical significance, logistic regression analysis revealed that three variables: age, visual acuity in the "best eye," and visual agnosia, correctly classified 91% of patients as hallucinators vs. non-hallucinators. This work supports a growing body of research showing a relationship between visual hallucinations and the visual system across a variety of disorders.