A 30-year-old female patient diagnosed with major depressive disorder has been prescribed fluoxetine. After several weeks, she reports persistent insomnia and sexual dysfunction. Which of the following medications could be considered as an alternative treatment option?
- A) Bupropion ✓
- B) Sertraline
- C) Venlafaxine
- D) Paroxetine
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat MDD. While effective for many patients, SSRIs can lead to side effects such as insomnia and sexual dysfunction. Insomnia may occur due to increased serotonin levels affecting sleep architecture, while sexual dysfunction can manifest as decreased libido, delayed orgasm, or anorgasmia.
Given the above evaluations, bupropion stands out as the most appropriate alternative treatment option for this patient due to its favorable side effect profile concerning both insomnia and sexual dysfunction. This medication is an atypical antidepressant that primarily acts on norepinephrine and dopamine reuptake inhibition. It is known for having a lower incidence of sexual side effects compared to SSRIs and may even improve sexual function in some patients. Additionally, bupropion is less likely to cause sedation, making it a suitable option for patients experiencing insomnia.
