- Email: [email protected]
P.1.128 Depressive symptoms and suicidal ideationamong college students: A study of 752 students in the Boston area
PI, Affeotiue cii~orciers and ant~cle.pre~saut~
$230
nonresponder to duloxetine did not show this pattern of decrease. The brain regions showing decreased cordance in duloxetine responders were similar to those in responders to venlafaxine and fluoxetine. Duloxetine responders showed decreases in cordance that may have been earlier and of a greater magnitude than those seen with the other antidepressants. C o n e l ~ i o ~ These results are consistent with those of previous brain imaging studies, and indicate that decreases in prefrontal cordance with duloxetine treatment may be a leading indicator of clinical response to this SNN:. Direct comparison of a lager number of subjects treated with duloxetine and other medications will be necessary to confirm these initial findings.
i.p.), while the antagonist had no effect in animals receiving agomelatine in the morning. These findings appear to confirm that the mechanism of antidepressant- and anxiolytic-like effects of melatonin involves the MT1/MT2 receptors and to suggest that these activities of agomelatine require its combined action at both the melatonin and the semtonin 5-HT2c receptors. Together, these results indicate that, in animals, agomelatine has more potent antidepressant and anxiolytic properties than melatonin. Moreover, the existence of serotonegic component deprives agomelatine of chmnobiotic dependence, which may have beneficial implication for its use in the therapy of depression/anxiety disorders.
References
References
Code IA, Lenohter AP, Morgan M, Witte E, S"cubbeman WF, Abrams M, Rosenberg S, Uijtdehaage SH. (2002) Early changes in prefrontal activity characterize clinical responders to antidepressants. Neuropsy&opharmaoolo~ 27:120-131. L~ehter, AE Cook IA, Witte EA, Abrams, M. (2002) Change~ in brain function of depressed subjects during treatment with placebo. Amerinan Journal of Psychiatry 159:122-129. Lmohter AP, Uijtdehaage SH, Cook IA, O'Hara R, Mandelkem M. (1999) Relationship between brain electrical activity and cortical pea'fusion in normal subjects. Psy&iatry Res Neuroimaging 90:12,5-40.
[ll Wilin~ ~ Psyohoph~ma~lo~, 199% 134, 31%329 [2] Papp I'd, Gruoa P, Boyer P-A, Mooa~r, Neuropsyohopharmaoology, 2003, 28, 694-703.
•
Evidence for antidepressant- and anxiolytic-like activities of melatonin and agomelatine in animal models
P. Gruca, E. Przegalinski, S. Mrowiec, M. Lason, M. Papp. Be]~aoioural P~armacology Laboratory, Inxt#ute
of P~armacology, Polis~ Academy of Sciences, Xrafow, Poland Melatonin and agomelatine, a mixed agonist of MT1/MT2, and antagonist of 5-I-IT2c receptors, are known to be involved in regulation of biological clocks. In the present study, melatonin and agomelatine are shown to possess an activity in an animal model of depression (chronic mild stress, CMS) [1,2] and in two animal models of anxiety (elevated plus-maze and Vogel conflict test). The above actions of agomelatine were comparable to those observed following similar administration of traditional antidepressant and anxiolytic drugs, imipramine, fluoxetine and diazepam, and stronger than those of melatonin. As expected, the antidepressant- and anxiolytic-like effects of melatonin and agomelatine clearly depended on the time of administration. Thus, in the CMS model melatonin (10 and 50 mg/kg) dose-dependently revemed the stress-induced anhedonia only if administered 2 hours before the dark phase of the 12-h light/dark cycle (evening administration), while agomelatine (10 and 50 mg/kg) was active also when administered 2 hours after the dark phase (morning administration), i.e. when it is devoid of chronobiotic activity. Melatonin (10-75 mg/kg) was inactive in the Vogel conflict teat and active in the elevated plus-maze only after the evening administration, whilst agomelatine (10-75 mg/kg) increased the number of open arms entries and punished responses following both the morning and evening administration. The activity of agomelatine in the Vogel conflict test did not depend on its time of administration, whereas its activity in the elevated plusmaze was obtained at lower dose after evening (from 10 mg/kg) than after morning (from 50 mg/kg) administration. Again, these anxiolytic-like effects of agomelatine were more potent than those of melatonin. Interestingly, in the CMS and the elevated plus-maze the effect of evening administration of melatonin and agomelatine was inhibited by the melatonin antagonist, $22153 (20 mg/kg
•
Depressive symptoms and suicidal ideation among college students: A study of 752 students in the Boston a r e a
S,B, Sonawalla, E, Beaumont, ¥, Mahal, D, Iosifescu, D, Mischoulon, J,E, Alpert, M, Fava, Ma~acf~u~ett~ General Ho~p#a4 H~oard Med~cal Sc~ool, P~yc~atry, Bo~to~, US, A,
Objective: To assess the prevalence of depressive symptoms and suicidal ideation among college students. l ~ t h o & 752 students at a college in the greater Boston area (mean age: 20.2 years4-7.6 years; 59..3% women) were screened for depressive symptoms. After obtaining written, informed consent, the Beck Depression Inventory (BDI) wa~ distributed to all students. Students who scored greater than or equal to 16 on the BDI and consented to be interviewed were evaluated using the MDD module of the Structured Clinical Interview for DSMIV (SCID-P). Students who met criteria for MDD on the SCID were further assessed using the 10-item Harvard Department of Psychiatry/National Depression Screening Day scale (HANDS) and a questionnaire. For the purpose of the analyses, significant depressive syrrptoma were defined as a score of >10 on the BDI. The chi-square, Mann Whitney-U test, Spearman Rank Correlation and unpaired t-teats were used for data analyses. Results: 19% of the students had significant depressive symptoms, as assessed by a score of >10 on the BDI, and 7.3% of the students scored >16 on the BDI. 14.4% of the students reported suicidal ideation (score of >1on BDI item #9). Age, gender and year in college did not predict suicidal ideation. Depression severity predicted suicidal ideation (P<0.0001). Women were significantly more likely to have a total BDI score >10 compared to men (22.4% vs 14.0%; chi-square = 8.3; P<0.01). 30% of the students reported sleep disturbances, as assessed by a score of >1 (item #16) on the BDI. Students who reported sleep disturbances were significantly more likely to have suicidal ideation, compared to those who did not (20% vs 11.9% respectively; chi-square = 8.5; P<0.01). C o n d ~ i o n : A substantial percentage of students in this sample reported experiencing significant depressive aymptems, suicidal ideation and sleep disturbances. More women than men experienced significant depressive wmptoms. This study highlights the importance of screening for depressive syrnptome in college populations, and suggests that depressive symptoms mayvarywith gender.
P1, Affection disorders and ant~@re~sam~ References
Sohotte CKW, Maes M, Cluydts R, De Donoker D, Cosyns P. Construct validity of the Be& Depression Inventory in a depressive population. Journal of Affeotive Disorders, VoNme 46, pp 115-125, 1997. Sonawalla SB, Kelly KE, Neault NB, Misdaoulon D, Farabaugh AH, Pava JA, Yenng A, Fava M. Predictors of suicidal ideation in a college population. 154th Annual Meeting of the American Psy&iatrio Association. New Orleans, Louisiana, 2001.
•
Depression and suicidal ideation among college students in Bombay: A study of 1357 individuals
R.M. P a r i ~ 1, S.B. Sonawalla 2, M. Fava 2, N. Chakraborthy, @. Mehra, S. Dracass. 1gaslok Hoxp~al and ~esearc~ Comer,
Psychiatry, Bombay, India; 2Massachusetts General Hospital, Harvard Medieal School, Psyehiatr N Bo~ton, U ~A, Objective-" The prevalence of significant depressive symptoms among college students has been reported by researchers (1, 2). The present study assesses depressNe symptoms and suicidal ideation among college students in Bombay. Metll~lS: We screened 1357 college students over the age of 18 years (mean age: 19.3+1.5 years; 56% women) in Bombay, India. After obtaining written, informed consent, the Beck Depression Inventory (BDI) and the Symptom Questionnaire (SQ) were distributed to all students. Chi-square and Mann Whitneq-LT tests were used for data analysis. Results: 24% of the students scored >16 on the BDI and 25% had suicidal ideation (as assessed by item #9 on the 1;DI). 31.6% men and 18.7% women scored > 16 on the t)I)I (chi-square=26.1; p<0.0001). There was no gender difference in the prevalence of suicidal ideation. Students who scored >16 on the t)DI also had significantly higher scores across all four SQ scales: SQ depression, SQ anxiety, SQ somatic symptoms and SQ angerhostility compared to those with t)DI scores of less than 16 (p<0.0001). Students who had suicidal ideation also scored had significantly higher across all four SQ scales: SQ depression, SQ anxiety, SQ somatic symptoms and SQ anger-hostility compared to those who did not have suicidal ideation (p<0.0001). Conelmiom Significant depressive symptoms are noted in 24% of this urban college population in India, with a high prevalence of suicidal ideation. Our study emphasizes the importance of screening for depression among college students and the need to plan effective intervention strategies in this population.
References Sonawalla SB, Kelly KE, Neault NB, Mis&oulon D, Farabaugh AH, Pava JA, Young A, Fava M. Predictors of suicidal ideation in a college population. 154th Annual Meeting of the American Psydaiatrie Association. New Orleans, Louisiana, 2001. I~arrios LO, Everett SA, Simon TP-,, Brener ND: SuiNde ideation among US college students. J Am Coil Health 2000; 48(,5):195-8.
•
Interactions between estrogen, scopolamine and venlafaxine in their influence on spatial m em cry i n ova riectom ized ra ts
K. Kus, E. Nowakowska, M. Lukaszewicz. Depar~z~ent of
Pflarmacology, U~ioers#y of Medical Sciences, goznan, Poland Postmenopausal low estrogen level in the central nervous system adversely affects mental function in women and may lead to
$231
depression. Estrogens have been proved to effectively facilitate antidepressant treatment, particularly in drug resistant depression. Estrogens have also been recently implicated to have some role in cognitive functions and neuroprotection. However, therapeutic status of estrogen replacement in postmenopausal cognitive deficits is not well defined. Recent studies indicate that estrogen enhances performance in learning and memory tests, both in animal models, and in humans. In laboratory animals, estrogenic influence depends upon the type of learning test, estrogen dose and estrous cycle in female rats. Venlafaxine is a representative of a new class of antidepressants which selectively inhibit the uptake of serotonin and noradrenaline but, in contrast to tricyclics, it shows no affinity for neurotransmitter receptors. Many drugs used in psychiatric therapy may improve, reduce or alter cognitive functions. The aim of this study has been to find out whether 17-betaestradiol and venlafaxine improve memory processes - b o t h intact and disrupted by scopolamine administration (blocker of central musearinergic receptors). The study was carried out on white, female Wistar rats of 8 0 250 g, ovariectomised at age 30-35 days in order to produce hypestrogenism. 17-beta-estradiol 5 I;g/kg s.c. was administered after ovariectomy for 4 weeks (2 weeks after ovariectomy and 2 weeks of the study) 180 rain prior the test. Venlafaxine (20 mg/kg) was administered (p.o.) 30 rain before the test. Scopolamine 0.5 mg/kg wa~ injected (i.p.) 30 rain before the test only. In chronic experiments venlafaxine was administered for 2 weeks. The memory assessment was performed with Morris water-maze test. Statistical analysis for memory test was done with nonparametric KruskalWallis's test for unpaired data and with Friedman test for paired data. Statistical significance was verified with post-hoe Dunn test. After single, 7-day and 14-day administration of venlafaxine lower values of escape latencies and lower number of crossed quadrants were noted which is indicative of performance improvement. After administration of estradiol in ovariectomized rats, there was a statistically significant effect in lower number of crossed quadrants only on day 14 of estradiol administration. Joint administration of estradiol and venlafaxine related improvement of spatial memory in ovariectomized rats group could be observed. Scopolamine produced memory worsening - the rats crossed more quadrants and had higher escape latencies than the control group. Both venlafaxine and estradiol prevented memory deficit induced by scopolamine. Estrogens, when administered with some antidepressants (venlafaxine), may be effective in improving cognition in pertmenopausal period related disorders, and thus may improve the standard of life in this population.
•
Adherence and tolerability of antidepressantinduced sexual dysfunction in depressionremitted Taiwanese patients: Gender difference
C.-F. Hung 1, J.-K. Wen 2, l©epartmer# of Psychia~W, Chang
Gung Memorial Hospital, Kao~iung, Ta~wan,"2123 ga Pei Rd, Niao Sung Hsiang, Kaohsius~g Hxien, Taiwan Intl'Od~e~om Antidepressant, especially selective serotonin reuptake inhibitors (SSRIs) are frequently associated with sexual dysfunction, Though depression remitted, sexual dysfunction can lead to patient dissatisfaction and decreased adherence to treatment which result in high risk of relapse. No study till now had
$230
nonresponder to duloxetine did not show this pattern of decrease. The brain regions showing decreased cordance in duloxetine responders were similar to those in responders to venlafaxine and fluoxetine. Duloxetine responders showed decreases in cordance that may have been earlier and of a greater magnitude than those seen with the other antidepressants. C o n e l ~ i o ~ These results are consistent with those of previous brain imaging studies, and indicate that decreases in prefrontal cordance with duloxetine treatment may be a leading indicator of clinical response to this SNN:. Direct comparison of a lager number of subjects treated with duloxetine and other medications will be necessary to confirm these initial findings.
i.p.), while the antagonist had no effect in animals receiving agomelatine in the morning. These findings appear to confirm that the mechanism of antidepressant- and anxiolytic-like effects of melatonin involves the MT1/MT2 receptors and to suggest that these activities of agomelatine require its combined action at both the melatonin and the semtonin 5-HT2c receptors. Together, these results indicate that, in animals, agomelatine has more potent antidepressant and anxiolytic properties than melatonin. Moreover, the existence of serotonegic component deprives agomelatine of chmnobiotic dependence, which may have beneficial implication for its use in the therapy of depression/anxiety disorders.
References
References
Code IA, Lenohter AP, Morgan M, Witte E, S"cubbeman WF, Abrams M, Rosenberg S, Uijtdehaage SH. (2002) Early changes in prefrontal activity characterize clinical responders to antidepressants. Neuropsy&opharmaoolo~ 27:120-131. L~ehter, AE Cook IA, Witte EA, Abrams, M. (2002) Change~ in brain function of depressed subjects during treatment with placebo. Amerinan Journal of Psychiatry 159:122-129. Lmohter AP, Uijtdehaage SH, Cook IA, O'Hara R, Mandelkem M. (1999) Relationship between brain electrical activity and cortical pea'fusion in normal subjects. Psy&iatry Res Neuroimaging 90:12,5-40.
[ll Wilin~ ~ Psyohoph~ma~lo~, 199% 134, 31%329 [2] Papp I'd, Gruoa P, Boyer P-A, Mooa~r, Neuropsyohopharmaoology, 2003, 28, 694-703.
•
Evidence for antidepressant- and anxiolytic-like activities of melatonin and agomelatine in animal models
P. Gruca, E. Przegalinski, S. Mrowiec, M. Lason, M. Papp. Be]~aoioural P~armacology Laboratory, Inxt#ute
of P~armacology, Polis~ Academy of Sciences, Xrafow, Poland Melatonin and agomelatine, a mixed agonist of MT1/MT2, and antagonist of 5-I-IT2c receptors, are known to be involved in regulation of biological clocks. In the present study, melatonin and agomelatine are shown to possess an activity in an animal model of depression (chronic mild stress, CMS) [1,2] and in two animal models of anxiety (elevated plus-maze and Vogel conflict test). The above actions of agomelatine were comparable to those observed following similar administration of traditional antidepressant and anxiolytic drugs, imipramine, fluoxetine and diazepam, and stronger than those of melatonin. As expected, the antidepressant- and anxiolytic-like effects of melatonin and agomelatine clearly depended on the time of administration. Thus, in the CMS model melatonin (10 and 50 mg/kg) dose-dependently revemed the stress-induced anhedonia only if administered 2 hours before the dark phase of the 12-h light/dark cycle (evening administration), while agomelatine (10 and 50 mg/kg) was active also when administered 2 hours after the dark phase (morning administration), i.e. when it is devoid of chronobiotic activity. Melatonin (10-75 mg/kg) was inactive in the Vogel conflict teat and active in the elevated plus-maze only after the evening administration, whilst agomelatine (10-75 mg/kg) increased the number of open arms entries and punished responses following both the morning and evening administration. The activity of agomelatine in the Vogel conflict test did not depend on its time of administration, whereas its activity in the elevated plusmaze was obtained at lower dose after evening (from 10 mg/kg) than after morning (from 50 mg/kg) administration. Again, these anxiolytic-like effects of agomelatine were more potent than those of melatonin. Interestingly, in the CMS and the elevated plus-maze the effect of evening administration of melatonin and agomelatine was inhibited by the melatonin antagonist, $22153 (20 mg/kg
•
Depressive symptoms and suicidal ideation among college students: A study of 752 students in the Boston a r e a
S,B, Sonawalla, E, Beaumont, ¥, Mahal, D, Iosifescu, D, Mischoulon, J,E, Alpert, M, Fava, Ma~acf~u~ett~ General Ho~p#a4 H~oard Med~cal Sc~ool, P~yc~atry, Bo~to~, US, A,
Objective: To assess the prevalence of depressive symptoms and suicidal ideation among college students. l ~ t h o & 752 students at a college in the greater Boston area (mean age: 20.2 years4-7.6 years; 59..3% women) were screened for depressive symptoms. After obtaining written, informed consent, the Beck Depression Inventory (BDI) wa~ distributed to all students. Students who scored greater than or equal to 16 on the BDI and consented to be interviewed were evaluated using the MDD module of the Structured Clinical Interview for DSMIV (SCID-P). Students who met criteria for MDD on the SCID were further assessed using the 10-item Harvard Department of Psychiatry/National Depression Screening Day scale (HANDS) and a questionnaire. For the purpose of the analyses, significant depressive syrrptoma were defined as a score of >10 on the BDI. The chi-square, Mann Whitney-U test, Spearman Rank Correlation and unpaired t-teats were used for data analyses. Results: 19% of the students had significant depressive symptoms, as assessed by a score of >10 on the BDI, and 7.3% of the students scored >16 on the BDI. 14.4% of the students reported suicidal ideation (score of >1on BDI item #9). Age, gender and year in college did not predict suicidal ideation. Depression severity predicted suicidal ideation (P<0.0001). Women were significantly more likely to have a total BDI score >10 compared to men (22.4% vs 14.0%; chi-square = 8.3; P<0.01). 30% of the students reported sleep disturbances, as assessed by a score of >1 (item #16) on the BDI. Students who reported sleep disturbances were significantly more likely to have suicidal ideation, compared to those who did not (20% vs 11.9% respectively; chi-square = 8.5; P<0.01). C o n d ~ i o n : A substantial percentage of students in this sample reported experiencing significant depressive aymptems, suicidal ideation and sleep disturbances. More women than men experienced significant depressive wmptoms. This study highlights the importance of screening for depressive syrnptome in college populations, and suggests that depressive symptoms mayvarywith gender.
P1, Affection disorders and ant~@re~sam~ References
Sohotte CKW, Maes M, Cluydts R, De Donoker D, Cosyns P. Construct validity of the Be& Depression Inventory in a depressive population. Journal of Affeotive Disorders, VoNme 46, pp 115-125, 1997. Sonawalla SB, Kelly KE, Neault NB, Misdaoulon D, Farabaugh AH, Pava JA, Yenng A, Fava M. Predictors of suicidal ideation in a college population. 154th Annual Meeting of the American Psy&iatrio Association. New Orleans, Louisiana, 2001.
•
Depression and suicidal ideation among college students in Bombay: A study of 1357 individuals
R.M. P a r i ~ 1, S.B. Sonawalla 2, M. Fava 2, N. Chakraborthy, @. Mehra, S. Dracass. 1gaslok Hoxp~al and ~esearc~ Comer,
Psychiatry, Bombay, India; 2Massachusetts General Hospital, Harvard Medieal School, Psyehiatr N Bo~ton, U ~A, Objective-" The prevalence of significant depressive symptoms among college students has been reported by researchers (1, 2). The present study assesses depressNe symptoms and suicidal ideation among college students in Bombay. Metll~lS: We screened 1357 college students over the age of 18 years (mean age: 19.3+1.5 years; 56% women) in Bombay, India. After obtaining written, informed consent, the Beck Depression Inventory (BDI) and the Symptom Questionnaire (SQ) were distributed to all students. Chi-square and Mann Whitneq-LT tests were used for data analysis. Results: 24% of the students scored >16 on the BDI and 25% had suicidal ideation (as assessed by item #9 on the 1;DI). 31.6% men and 18.7% women scored > 16 on the t)I)I (chi-square=26.1; p<0.0001). There was no gender difference in the prevalence of suicidal ideation. Students who scored >16 on the t)DI also had significantly higher scores across all four SQ scales: SQ depression, SQ anxiety, SQ somatic symptoms and SQ angerhostility compared to those with t)DI scores of less than 16 (p<0.0001). Students who had suicidal ideation also scored had significantly higher across all four SQ scales: SQ depression, SQ anxiety, SQ somatic symptoms and SQ anger-hostility compared to those who did not have suicidal ideation (p<0.0001). Conelmiom Significant depressive symptoms are noted in 24% of this urban college population in India, with a high prevalence of suicidal ideation. Our study emphasizes the importance of screening for depression among college students and the need to plan effective intervention strategies in this population.
References Sonawalla SB, Kelly KE, Neault NB, Mis&oulon D, Farabaugh AH, Pava JA, Young A, Fava M. Predictors of suicidal ideation in a college population. 154th Annual Meeting of the American Psydaiatrie Association. New Orleans, Louisiana, 2001. I~arrios LO, Everett SA, Simon TP-,, Brener ND: SuiNde ideation among US college students. J Am Coil Health 2000; 48(,5):195-8.
•
Interactions between estrogen, scopolamine and venlafaxine in their influence on spatial m em cry i n ova riectom ized ra ts
K. Kus, E. Nowakowska, M. Lukaszewicz. Depar~z~ent of
Pflarmacology, U~ioers#y of Medical Sciences, goznan, Poland Postmenopausal low estrogen level in the central nervous system adversely affects mental function in women and may lead to
$231
depression. Estrogens have been proved to effectively facilitate antidepressant treatment, particularly in drug resistant depression. Estrogens have also been recently implicated to have some role in cognitive functions and neuroprotection. However, therapeutic status of estrogen replacement in postmenopausal cognitive deficits is not well defined. Recent studies indicate that estrogen enhances performance in learning and memory tests, both in animal models, and in humans. In laboratory animals, estrogenic influence depends upon the type of learning test, estrogen dose and estrous cycle in female rats. Venlafaxine is a representative of a new class of antidepressants which selectively inhibit the uptake of serotonin and noradrenaline but, in contrast to tricyclics, it shows no affinity for neurotransmitter receptors. Many drugs used in psychiatric therapy may improve, reduce or alter cognitive functions. The aim of this study has been to find out whether 17-betaestradiol and venlafaxine improve memory processes - b o t h intact and disrupted by scopolamine administration (blocker of central musearinergic receptors). The study was carried out on white, female Wistar rats of 8 0 250 g, ovariectomised at age 30-35 days in order to produce hypestrogenism. 17-beta-estradiol 5 I;g/kg s.c. was administered after ovariectomy for 4 weeks (2 weeks after ovariectomy and 2 weeks of the study) 180 rain prior the test. Venlafaxine (20 mg/kg) was administered (p.o.) 30 rain before the test. Scopolamine 0.5 mg/kg wa~ injected (i.p.) 30 rain before the test only. In chronic experiments venlafaxine was administered for 2 weeks. The memory assessment was performed with Morris water-maze test. Statistical analysis for memory test was done with nonparametric KruskalWallis's test for unpaired data and with Friedman test for paired data. Statistical significance was verified with post-hoe Dunn test. After single, 7-day and 14-day administration of venlafaxine lower values of escape latencies and lower number of crossed quadrants were noted which is indicative of performance improvement. After administration of estradiol in ovariectomized rats, there was a statistically significant effect in lower number of crossed quadrants only on day 14 of estradiol administration. Joint administration of estradiol and venlafaxine related improvement of spatial memory in ovariectomized rats group could be observed. Scopolamine produced memory worsening - the rats crossed more quadrants and had higher escape latencies than the control group. Both venlafaxine and estradiol prevented memory deficit induced by scopolamine. Estrogens, when administered with some antidepressants (venlafaxine), may be effective in improving cognition in pertmenopausal period related disorders, and thus may improve the standard of life in this population.
•
Adherence and tolerability of antidepressantinduced sexual dysfunction in depressionremitted Taiwanese patients: Gender difference
C.-F. Hung 1, J.-K. Wen 2, l©epartmer# of Psychia~W, Chang
Gung Memorial Hospital, Kao~iung, Ta~wan,"2123 ga Pei Rd, Niao Sung Hsiang, Kaohsius~g Hxien, Taiwan Intl'Od~e~om Antidepressant, especially selective serotonin reuptake inhibitors (SSRIs) are frequently associated with sexual dysfunction, Though depression remitted, sexual dysfunction can lead to patient dissatisfaction and decreased adherence to treatment which result in high risk of relapse. No study till now had