Assessment of sexual dysfunction in depressed patients and reporting attitudes in routine daily practice: Results of the postmarketing observational studies with moclobemide, a reversible MAO-A inhibitor.

Object: The aim of this study was to assess the effect of moclobemide on sexual dysfunction in depressed patients treated under routine conditions in private practice and hospital settings.

Method: sexual function was systematically assessed by a specific questionnaire and by recording spontaneously reported adverse events during large prospective postmarketing surveillance studies with moclobemide, carried out in Germany between 1992 and 1995. The data of 4333 patients were collected in two different settings: (a) specialized psychiatric and neurological private practices and (b) psychiatric hospitals.

Results: Up to 70% of depressed patients suffered from Some type of sexual dysfunction at baseline and in about two thirds the dysfunction was rated as moderate to severe. The severity and frequency of sexual dysfunction corresponded well to the severity of depressive syndrome. Sexual functions improved during treatment with moclobemide and the extent of improvement corresponded to the favourable outcome of antidepressant treatment. Deterioration of sexual functions under moclobemide treatment was infrequent and experienced by less than 3% of patients. The frequency of spontaneously reported sexual dysfunction, reported as adverse event, was lower than 0.1%. For a considerable proportion of patients included in the studies sexual function was not systematically recorded: up to 10-20% of data for variables related to sexual function were missing. Unreported sexual functioning varied in dependence of the type of function, age and gender of the patient and treatment settings.

Conclusion: The results of the observational studies with moclobemide do not provide evidence that moclobemide induces or intensifies sexual dysfunction in depressed patients under routine daily treatment. The results also demonstrate that the assessment of sexual function in the practice is clearly influenced by the reporting attitudes of patients and physicians.