Genetic polymorphism and serotonergic antidepressant related sexual dysfunction

Patients with depression usually experience sexual dysfunction, which could result from numerous causes, including depression itself, physical illness, comorbid psychiatric disorder, and its treatment, that is, serotonergic antidepressants. This study is to investigate the relationship between serotonin receptor polymorphism and serotonergic antidepressant-induced sexual dysfunction. Cases will be collected prospectively until a total of approximately 100 subjects have been collected. Subjects with major depressive disorder or dysthymic disorder, who receive serotonergic antidepressant(s) will be enrolled in the study. Initially all participants will be rated by the Hamilton Rating Scale for Depression (HAMD) and the Arizona Sexual Experience Scale (ASEX). We use buccal cheek swaps to obtain material for genotyping the A(-1438)G promoter polymorphism of the 5-hydroxytryptamine 2a receptor. We will evaluate all participants using HAMD and ASEX after 4 weeks (or at the time they are discharged from our hospital). Subjects who have response to antidepressant but complain of sexual dysfunction will be compared with those who do not have sexual dysfunction. Sexual dysfunction is defined as having either a score of 5 or more on any item or a total score of 17 or more on ASEX. A total score of 14 or less on HAMD is defined as having response to antidepressant.