Antidepressant Bupropion Found to Ease Sexual Dysfunction in MS

Daily treatment with an oral antidepressant called bupropion — marketed as Wellbutrin and Zyban, among others — significantly improved some aspects of sexual function in women with multiple sclerosis (MS), according to the results of a randomized trial in Iran.

“The results of our study showed bupropion can have promising effects on [sexual dysfunction] of female patients with MS,” the researchers wrote, noting improvements in “sexual desire, vaginal moisture, and orgasm intensity.”

Moreover, the treatment also eased fatigue, anxiety, and depression, and showed no concerning safety signals.

Overall, the researchers noted that bupropion “exerted beneficial effects on some areas of quality of life,” though patients reported the therapy failed to improve sexual satisfaction.

The study, “The effects of bupropion on sexual dysfunction in female patients with multiple sclerosis: A double-blind randomized clinical trial,” was published in Multiple Sclerosis and Related Disorders.

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Sexual dysfunction is common among MS patients, affecting up to 80% of women and 90% of men. Yet, these disruptive symptoms are often neglected in the healthcare setting, with reports indicating that many patients never discuss the issue with their doctors.

New solutions are needed for treating sexual dysfunction in MS patients, according to researchers — who, in this case, turned to an older medication.

Evidence suggests that modulating certain signaling chemicals in the brain may be able to overcome problems with sexual arousal.

Specifically, an antidepressant called bupropion — first approved in the U.S. in 1985 — works to increase levels of norepinephrine and dopamine, two important signaling molecules in the brain. These signaling molecules are involved in sexual desire, arousal, and orgasm.

To investigate the effects of bupropion on sexual dysfunction in women with MS, researchers in Iran conducted a clinical trial involving 64 patients, all 18 or older, and both living with MS and sexually active for the previous six months.

The participants were randomly assigned to receive oral bupropion tablets (75 mg) or a placebo, for 12 weeks, or about three months. Each received a single daily tablet over the first week, followed by twice-daily tablets for the subsequent 11 weeks.

The mean age of patients in the bupropion was 30.6, compared with 32.8 in the placebo group.

At the study’s start, all women had sexual dysfunction, defined as a score of 27 or higher on the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), which probes how MS symptoms interfere with sexual ability.

Bupropion treatment was associated with significant reductions in MSISQ-19 scores after six and 12 weeks, reflecting an overall improvement in sexual function. This improvement was significant compared with the placebo group, which did not see gains in sexual function at either time point.

Improvements were generally seen across most subscales of the MSISQ-19, including sexual satisfaction and desire, vaginal moisture, and orgasm intensity. Yet, patients still reported that they noticed no improvements in sexual satisfaction, the researchers noted.

Bupropion also was associated with significant reductions in fatigue, anxiety, and depression relative to the placebo group at six and 12 weeks. But overall quality of life was not significantly improved in either group.

A total of 20 side effects were reported during the study. The most common included anorexia, nausea, and vomiting, which were usually mild or moderate. Side effects typically occurred early in the study and became less severe or disappeared by the end of treatment.

Overall, “bupropion use in female patients with MS can be an effective therapeutic intervention in improving some aspects of sexual dysfunction,” the researchers wrote.

These findings are in line with another previous study of women with MS living in Iran, according to the team. That study found that daily bupropion improved sexual function, and eased fatigue and depression.

“We suggest that further studies be conducted with a larger sample size and in several medical centers to obtain more complete and comprehensive information,” the researchers wrote, noting that such studies should address the complexity of sexual dysfunction by including evaluations of anatomy, physical disability, and cultural conventions.