Hypersexuality in menopausal women using serotonin reuptake inhibitors

Abstract

Introduction Hypersexuality associated with SSRI use in postmenopausal women is a rarely documented phenomenon. Only one case had been reported in the literature prior to our findings. Objective The objective is to explore the association between the use of fluoxetine and bupropion in menopausal women and the onset of hypersexual behaviors. Methods This study involved the analysis of two clinical cases concerning postmenopausal patients treated with a combination of fluoxetine (125 mg/day) and bupropion (150 mg BID) for depression. Results In the first case, a 56-year-old patient developed uncontrollable sexual behavior, engaging with multiple partners, which led to marital separation. Her compulsive behavior began one week after fluoxetine was added to her ongoing bupropion regimen. In the second case, a 58-year-old woman exhibited similar hypersexual behavior following the same fluoxetine and bupropion combination, resulting in divorce after her partner discovered the behavior. Both cases, referred by different psychiatrists, experienced full symptom resolution upon discontinuation of the medications. Conclusions These cases suggest a potential association between SSRI use (specifically the combination of fluoxetine and bupropion) and hypersexual behavior in menopausal women. It is essential to consider even rare adverse effects of these medications. Psychiatrists should remain alert to the possibility that depressive symptoms emerging during perimenopause may stem from hypoestrogenism, and therefore, hormone replacement therapy might be more appropriate than antidepressant treatment. Disclosure No