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Antidepressant nonadherence and sexual dysfunction among young adult males: the cross-sectional YAMAN study

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Abstract

Purpose

Selective serotonin reuptake inhibitors are associated with high rates of nonadherence and sexual dysfunction, yet the correlation between these findings in young adult men is poorly characterized. We aimed to evaluate if young adult men are less willing to adhere to antidepressant treatment due to intolerable side effects, such as sexual dysfunction.

Methods

Deidentified, compensated survey that assessed baseline demographics, PHQ-8 and GAD-7 scores, attitudes towards antidepressant medication side effects, and perceptions of antidepressant medications including selective serotonin reuptake inhibitors, bupropion, and mirtazapine.

Results

From 665 delivered surveys, 505 respondents completed their survey (response rate: 76%), of which 486 were included for final analysis. After seeing common side effect profiles, our sample’s willingness to take sexual function-sparing agents, such as bupropion or mirtazapine, was significantly greater than selective serotonin reuptake inhibitors (p < 0.001), with no significant difference between bupropion and mirtazapine (p = 0.263). The negative influence of erectile dysfunction and anorgasmia scored significantly higher than other common antidepressant side effects like weight gain, nausea, and dry mouth (range: p < 0.001, p = 0.043). With the exception of insomnia, participants indicated that experiencing sexual dysfunction while taking an antidepressant medication would lead to nonadherence at a significantly higher frequency than any other side effect assessed (range: p < 0.001, p = 0.005).

Conclusion

The risk of experiencing sexual side effects when taking antidepressants could lead young adult men to become nonadherent to these medications. Strategies to augment the effectiveness of antidepressants, such as shared decision-making and the use of sexual function-sparing agents, are critical.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Acknowledgements

We thank the Sexual Medicine Society of North America for their generous “Scholars in Sexuality Research Grant” award enabling the creation of this work. We would also like to recognize Dr. James Aluri and Dr. Vinay Parekh for their contribution to the conceptualization of this project from the Department of Psychiatry. We also recognize the Johns Hopkins University Biostatistics, Epidemiology and Data Management (BEAD) Core for their assistance. Finally, we thank Dr. Dolores Lamb and Dr. Arthur Burnett for their invaluable mentorship and guidance throughout the duration of this project.

Funding

This project was funded by the 2022 SMSNA Scholars in Sexuality Research Grant Program (PI: Matthew Rabinowitz; Grant Title: Anti-Depressant Non-adherence and the Prioritization of Sexual Function in Young Men) and generous philanthropic donations from patients of Dr. Amin Herati.

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Authors and Affiliations

  1. The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Oscar Li, Ellen H. Pil, Taylor P. Kohn, Nora M. Haney & Amin S. Herati

  2. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Cyd K. Eaton

  3. Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Matthew J. Rabinowitz

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  1. Matthew J. Rabinowitz
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  2. Oscar Li
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  7. Amin S. Herati
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Contributions

M. J. Rabinowitz: Protocol/project development; Data Analysis; Manuscript writing/editing. O. Li: Data collection or management; Manuscript writing/editing. E. Pi: Data collection or management; Manuscript writing/editing. C. K. Eaton: Protocol/project development; Data collection or management; Data Analysis; Manuscript writing/editing. T. P. Kohn: Protocol/project development; Manuscript writing/editing. N. M. Haney: Manuscript writing/editing. A. S. Herati: Protocol/project development; Manuscript writing/editing.

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Correspondence to Amin S. Herati.

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Rabinowitz, M.J., Li, O., Pil, E.H. et al. Antidepressant nonadherence and sexual dysfunction among young adult males: the cross-sectional YAMAN study. World J Urol 42, 295 (2024). https://doi.org/10.1007/s00345-024-05003-3

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