Effect of Antidepressants on Sex Hormone Levels and Sexual Functioning
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Purpose
This study will evaluate the effect of antidepressants on sex hormone levels in women and if the potential changes in sex hormone levels are related to sexual side effects.
| Condition | Intervention | Phase |
|---|---|---|
|
Healthy |
Drug: Fluoxetine Drug: Bupropion |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Health Services Research |
| Official Title: | Effect of Serotonin Reuptake Inhibitors on Gonadal Steroid Hormones |
- 17-OH-pregnenolone [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Arizona Sexual Experiences Scale (ASEX) [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Free testosterone [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Estradiol [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Prolactin [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Progesterone [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Dehydroepiandrosterone Sulfate (DHEA-S) [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Androstenedione [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- C-reactive protein [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Inflammatory cytokines [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
- Lymphocyte activation markers [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
| Enrollment: | 80 |
| Study Start Date: | October 2005 |
| Study Completion Date: | September 2008 |
| Primary Completion Date: | May 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: A
Participants will receive treatment with fluoxetine for 2 months
|
Drug: Fluoxetine
Participants will begin taking 10 mg of fluoxetine, once a day by mouth, on the first day of their second menstrual cycle during the study. Dosage will be increased to 20 mg of fluoxetine once a day after 7 days, to be maintained until the luteal phase (start of ovulation) of menstrual cycle 3. If side effects are intolerable, the dose will be lowered to 10 mg of fluoxetine per day. Participants will undergo a total of 2 months of treatment with fluoxetine.
Other Name: Prozac, Serafem
|
|
Experimental: B
Participants will receive treatment with bupropion for 2 months
|
Drug: Bupropion
Participants will begin taking 150 mg of bupropion, once a day by mouth, on the first day of their second menstrual cycle during the study. Dosage will be increased to 300 mg of bupropion once a day after 7 days, to be maintained until the luteal phase of menstrual cycle 3. If side effects are intolerable, the dose will be decreased to 150 mg of bupropion per day. Participants will undergo a total of 2 months of treatment with bupropion.
Other Name: Wellbutrin, Zyban
|
Detailed Description:
Depression is a leading cause of disability in women, with women being two times more likely than men to develop depression. Depression affects a person's body, thoughts, mood, and behavior, often making normal day-to-day functioning difficult. Fortunately, depression is a condition that is highly treatable with one or more of the antidepressant medications and forms of psychotherapy available. Serotonin reuptake inhibitors (SRIs) are a recent class of antidepressants that have been successful in alleviating symptoms of depression. Although the side effects of SRIs are less than those of other types of antidepressants, a number of people taking SRIs experience sexual dysfunction, including reduced desire and difficulty with orgasm. It is believed that SRI treatment may interfere with gonadal production of steroid hormones, thus leading to changes in sexual function. This study will compare the effects of the SRI fluoxetine with the effects of the non-SRI bupropion on circulating levels of sex hormones in healthy women and on any related sexual side effects.
Participation in this study will last 3 months. Potential participants will undergo initial screening, which will involve a blood draw, drug and pregnancy tests, physical exam, electrocardiogram, and psychiatric diagnostic interview. Participants will also complete an interview and questionnaire about sexual functioning. All eligible participants will then be asked to return for a total of 9 study visits over 3 months.
Participants will undergo 1 month of baseline hormonal sampling and 2 months of daily treatment with either fluoxetine or bupropion. The study visits will be scheduled around three points in the menstrual cycle (early follicular, ovulatory, and luteal), with each visit including a blood draw and repeat questionnaire on sexual functioning. Participants will be asked to perform daily urine tests, beginning 10 days after the start of menstruation and continuing for up to 8 days until detection of the luteinizing hormone surge, which signals ovulation. Participants will be asked to keep a diary of luteinizing hormone surges, dates of menstruation, and sexual activities. At the Month 3 visit, participants will discontinue their assigned medication and will complete their final blood draw and questionnaire.
Eligibility| Ages Eligible for Study: | 18 Years to 45 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Regular menstrual cycles that are 25 to 35 days in length during the 1 year prior to study entry
- Willing to engage in sexual activity, alone or with a partner, at least weekly for the duration of the study
- Willing to use effective birth control (e.g., condom, diaphragm with spermicide, tubal ligation, nonhormonal IUD, partner with vasectomy) for the duration of the study
Exclusion Criteria:
- Medical illness that may contribute to sexual dysfunction or affect steroid hormone levels
- Body mass index (BMI) greater than 30
- Elevated testosterone at screening
- History of seizure disorder
- Consumes more than 10 alcoholic beverages per week
Contacts and Locations More Information
No publications provided
| Responsible Party: | Margaret Altemus, Associate Professor, Weill Medical College of Cornell University |
| ClinicalTrials.gov Identifier: | NCT00611975 History of Changes |
| Other Study ID Numbers: | R21 MH071543, R21MH071543, DNBBS 73-MCR |
| Study First Received: | February 6, 2008 |
| Last Updated: | June 27, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by Weill Medical College of Cornell University:
|
Gonadal Steroid Hormones Healthy Volunteers Antidepressant Side Effects Fluoxetine Bupropion Prolactin |
Testosterone Estradiol Progesterone Sexual Function Serotonin Reuptake Inhibitors 17-OH Pregnenolone |
Additional relevant MeSH terms:
|
Antidepressive Agents Fluoxetine Bupropion Serotonin Uptake Inhibitors Hormones Psychotropic Drugs Central Nervous System Agents Therapeutic Uses Pharmacologic Actions |
Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Serotonin Agents Physiological Effects of Drugs Antidepressive Agents, Second-Generation Hormones, Hormone Substitutes, and Hormone Antagonists Dopamine Uptake Inhibitors Dopamine Agents |
ClinicalTrials.gov processed this record on May 21, 2013