New antidepressant offers hope for patients with reduced sexual side effects

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Bupropion is a norepinephrine dopamine reuptake inhibitor (NDRI); it is indicated for the treatment of depression, and also prevents the recurrence and relapse of future episodes in patients who respond well to the treatment.

Moreover, bupropion has a favourable safety profile, with a low incidence of sexual side effects or treatment emergent sexual dysfunction (TESD) compared to other antidepressants.

Abdurahmaan Kenny, mental health portfolio manager for Pharma Dynamics explains, “Several factors may contribute to why it causes less sexual dysfunction in some patients compared to other antidepressants. These include its unique pharmacological profile, dopaminergic activity, minimal serotonin impact and lower rates of anticholinergic effects.

“Bupropion’s mechanism of action is distinct from that of many other antidepressants. While most antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), primarily target serotonin and/or norepinephrine levels in the brain, bupropion mainly affects the levels of dopamine and norepinephrine.

Its enhancement of dopamine levels in the brain may also counteract the sexual side effects associated with reduced dopamine activity that can occur with other antidepressants. Because dopamine plays a key role in sexual arousal and desire, bupropion’s action on dopamine may, therefore, help maintain or even improve sexual function for some individuals.

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“Unlike many other antidepressants, Prodyna XR has a limited impact on serotonin levels. Sexual dysfunction is a common side effect of drugs that increase serotonin, as serotonin is also involved in regulating sexual response. By not significantly affecting serotonin, it may avoid some of the sexual side effects associated with serotonin-modulating antidepressants.

“Anticholinergic effects are side effects commonly associated with some antidepressants, and they can include sexual dysfunction. Bupropion has a lower likelihood of causing anticholinergic side effects, which may contribute to its reduced impact on sexual function.”

Kenny says it’s important to note that while the treatment has a lower risk of causing sexual dysfunction for some individuals, it’s not a one-size-fits-all approach.

“While sexual dysfunction isn’t often reported by patients, TESD should be screened for. Once diagnosed, healthcare providers can provide guidance on treatment options, potential adjustments to a medication regimen or the addition of strategies to manage sexual side effects,” Kenny adds.

Prodyna XR150 mg and 300 mg is accessible in packs of 30s and is available at all leading pharmacies.