Clinical trial NCT00611975: Effect of Antidepressants on Sex Hormone Levels and Sexual Functioning
Official title: Effect of Serotonin Reuptake Inhibitors on Gonadal Steroid Hormones
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Healthy
Keywords: Gonadal Steroid Hormones
Healthy Volunteers
Antidepressant Side Effects
Fluoxetine
Bupropion
Prolactin
Testosterone
Estradiol
Progesterone
Sexual Function
Serotonin Reuptake Inhibitors
17-OH Pregnenolone
Lead sponsor: Weill Medical College of Cornell University
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2008-02-11
Enrollment: 83
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: 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.

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 criteria: 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 intrauterine device,, 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

Primary outcomes:
measure: Change in 17-OH Pregnenolone
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
Secondary outcomes:
measure: Change in Arizona Sexual Experiences Scale (ASEX)
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Free Testosterone
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Estradiol
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Prolactin
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Progesterone
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Dehydroepiandrosterone Sulfate (DHEA-S)
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Change in Androstenedione
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: C-reactive Protein
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Inflammatory Cytokines
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
measure: Lymphocyte Activation Markers
timeFrame: Measured in baseline menstrual cycle and during antidepressant treatment for two menstrual cycles
Other outcomes:
Locations:
Study officials:
affiliation: Weill Medical College of Cornell University
name: Margaret Altemus, MD
role: PRINCIPAL_INVESTIGATOR
References: