Researcher Dr. Kristian Jensen dons a headset composed of 256 electrodes that indirectly gauges serotonin levels. Signe Ghodt
As stated by CNN
After starting antidepressants, many people feel relief, but some experience sexual side effects. Estimates vary, and they occur in about 25%–80% of patients during treatment.
There is now an opportunity to use a new tool that could help patients reduce risk and preserve sexual health during psychopharmacotherapy, drawing on prior research.
Although the issue of sexual disturbances during antidepressant use has been known since the 1960s, there was no way to predict the likelihood of problems with libido, arousal, orgasm, or erectile function before beginning treatment.
What is the brain test and what does it measure
It is a painless and non-invasive procedure – electroencephalography (EEG). During it, tiny electrodes are placed on the scalp to record the brain’s electrical activity. The test identifies a biomarker called the loudness dependence of auditory-evoked potentials (LDAEP), which reflects serotonin activity that affects libido, mood, sleep, and processing of sensory information.
According to researchers, a lower LDAEP level corresponds to higher serotonin activity. SSRIs – selective serotonin reuptake inhibitors – increase available serotonin in the brain, which can improve mood, but sometimes lead to sexual problems.
The authors believe that LDAEP may serve as a tool for predicting response to psychopharmacotherapy, but it requires further confirmation in clinical studies and publications in scientific journals.
In a previous study with 90 participants diagnosed with major depressive disorder, it was shown that lower LDAEP values (i.e., higher serotonin levels) predicted orgasmic dysfunction after eight weeks of treatment with escitalopram with an approximate accuracy of about 87%. A larger study with 600 participants is now planned to test these findings on a larger sample.
Experts emphasize that LDAEP is not a direct measure of serotonin activity and requires confirmation in peer-reviewed publications. A placebo-controlled study would also be desirable to enhance the validity of the conclusions.
According to the study, more than 11% of the US adult population in 2023 were taking antidepressants for depression; many people are also treated for other mental disorders. The role of serotonin in reducing blood flow and muscle tension in the genital organs may explain why some medications affect sexual function.
Experts also note that for some patients an alternative drug – bupropion, a norepinephrine and dopamine reuptake inhibitor, which does not significantly raise serotonin and may support sexual desire. If sexual problems have already arisen during antidepressant use, it’s worth consulting a doctor to adjust the regimen or add supportive therapy to reduce discomfort and preserve quality of life.
What does this mean for patients and doctors
The possibility of using a brain test to predict treatment response opens the way to personalized therapy: selecting medications with minimal impact on the sexual sphere or planning preventive or additional therapy. However, the role of LDAEP as a predictor of response to therapy requires confirmation in large studies and publications in scientific journals.
For patients it’s important to discuss any disruptions in sexual function with a doctor – this can help tailor the treatment plan or add supportive therapy to reduce discomfort and preserve quality of life.
Prospects and Future Research
According to researchers’ plans, upcoming studies will involve about 600 participants to test the earlier findings in a larger sample. Publications in peer-reviewed journals and further placebo-controlled studies will be important to confirm the reliability of the results.
