Dovepress Rosa damascena oil for male SSRI-induced sexual dysfunction Table 2 Overview of the inferential statistics for the factors time(baseline,week 4,week 8)and group (verum versus placebo)with sexual function as the dependent variable Time Group Time x group Greenhouse- Post hoc analyses interaction Geisser epsilon Degrees of freedom (2,132) (,66) (2,132) Time Group Fn2(EF) Fn2(EF) Fn2(EF) Sexual drive 13.65*0.171() 1230.018() 3.98*0.056(M） 0.827 W8>W4.BL V>PL at W8 Erections 23.04*0.259(L) 0.190.003(S) 9.12*0.121(M 0.793 W8>W4.BL V>PL at W8 Ejaculations 30.88*0.319()） 1.I10.017(S 5.91*0.078(M 0.662 W8>W4.BL V>PL at W8 Problem assessment 30.72*0.319(L) 0.960.008(S) 5.56*0.082(M 0.736 W8>W4.BL V>PL at W8 Overall satisfaction 30.12*0.354(L) 0.900.012(S) 4.59*0.065(M 0.686 W8>W4.BL V>PL at W8 Mean score 34.43*0.343(L) 0.720.010(⑤) 723钟0.100(M 0.659 W8>W4.BL V>PL at W8 Degrees of freedom (0,66) (1,66) (1,66) Fn2(EF) Fn2(EF) Fn2(EF) Beck depression inventory 11.82**0.182 (L) 0.770.001(S 9.07*0.131(M 1.00 Notes:*=P<0.05;**=P<0.0I:**=P<0.001."W8>W4,BL"indicates that all values at week 8 were statistically higher than the values at week 4 and at baseline."V>PL at W8"indicates that at week 8,values of the verum group were statistically higher than the values of the placebo group. Abbreviations:EF,effect size:S.small effect size;M,medium effect size;L.large effect size;W8,week 8:W4.week 4;BL baseline;V.verum;PL,placebo were unrelated (all rs<10.131,ps>0.38);for the placebo placebo did.Symptoms of depression decreased in parallel, group,more severe symptoms of depression at baseline pre- but not linearly.These results confirm the positive effect of dicted greater sexual dysfunction at baseline,and after 4 and R.damascena oil on SSRI-I SD in a double-blind,random- 8 weeks(rs>0.35,ps<0.05).A greater severity of depression ized,and placebo-controlled clinical trial and provide an symptoms after 8 weeks was associated with greater sexual important contribution to the literature on this condition. dysfunction after weeks 4 and 8 of the study (rs>0.38, Three hypotheses were formulated.Our first hypothesis ps<0.05),but not with sexual dysfunction at baseline. was that the administration of R.damascena oil would improve sexual dysfunction more than a placebo would,and Discussion this theory was fully supported.Accordingly,the present The key findings of the present study are that among male study is a contribution to the current literature because,to patients suffering from both MDD and SSRI-ISD while being the best of our knowledge,for the first time the success of treated with an SSRI standard medication,adjuvant admin- an agent in the treatment of an SSRI-I SD in male patients istration of R.damascena oil improved sexual dysfunction suffering from MDD was proven in a double-blind,random- after 8 weeks more than the adjuvant administration of the ized,and placebo-controlled clinical trial. 4.0 30 35 ◆=Verum ■Placebo ◆=Verum-d-Placebo 25 25 20 2.0 15 品 10 1.0 0.5 5 0.0- Baseline Week 4 Week 8 0 Baseline Week 8(end of study) (end of study) Time points Time points Figure 3 Comparison of BDI scores between verum and placebo groups. Figure 2 Comparison of sexual function between verum and placebo groups Notes:Over time,symptoms of depression(BDI scores)decreased significantly Notes:Over time,sexual dysfunction improved significantly more in the verum more in the verum(Rosa damascena extract)group than in the placebo group.Points (Rosa damascena oil)group than in the placebo group.Points are means,and bars are means,and bars are standard deviations. are standard errors. Abbreviation:BDI,Beck Depression Inventory. Neuropsychiatric Disease and Treatment 2015:1I 631 DovepressNeuropsychiatric Disease and Treatment 2015:11 submit your manuscript | www.dovepress.com Dovepress Dovepress 631 Rosa damascena oil for male SSRI-induced sexual dysfunction were unrelated (all rs,0.13, ps.0.38); for the placebo group, more severe symptoms of depression at baseline pre￾dicted greater sexual dysfunction at baseline, and after 4 and 8 weeks (rs.0.35, ps,0.05). A greater severity of depression symptoms after 8 weeks was associated with greater sexual dysfunction after weeks 4 and 8 of the study (rs.0.38, ps,0.05), but not with sexual dysfunction at baseline. Discussion The key findings of the present study are that among male patients suffering from both MDD and SSRI-I SD while being treated with an SSRI standard medication, adjuvant admin￾istration of R. damascena oil improved sexual dysfunction after 8 weeks more than the adjuvant administration of the placebo did. Symptoms of depression decreased in parallel, but not linearly. These results confirm the positive effect of R. damascena oil on SSRI-I SD in a double-blind, random￾ized, and placebo-controlled clinical trial and provide an important contribution to the literature on this condition. Three hypotheses were formulated. Our first hypothesis was that the administration of R. damascena oil would improve sexual dysfunction more than a placebo would, and this theory was fully supported. Accordingly, the present study is a contribution to the current literature because, to the best of our knowledge, for the first time the success of an agent in the treatment of an SSRI-I SD in male patients suffering from MDD was proven in a double-blind, random￾ized, and placebo-controlled clinical trial. Table 2 Overview of the inferential statistics for the factors time (baseline, week 4, week 8) and group (verum versus placebo) with sexual function as the dependent variable Time Group Time × group interaction Greenhouse– Geisser epsilon Post hoc analyses Degrees of freedom (2, 132) (1, 66) (2, 132) Time Group F η2 (EF) F η2 (EF) F η2 (EF) Sexual drive 13.65*** 0.171 (L) 1.23 0.018 (S) 3.98* 0.056 (M) 0.827 W8 . W4, BL V . PL at W8 Erections 23.04*** 0.259 (L) 0.19 0.003 (S) 9.12** 0.121 (M) 0.793 W8 . W4, BL V . PL at W8 Ejaculations 30.88*** 0.319 (L) 1.11 0.017 (S) 5.91** 0.078 (M) 0.662 W8 . W4, BL V . PL at W8 Problem assessment 30.72*** 0.319 (L) 0.96 0.008 (S) 5.56** 0.082 (M) 0.736 W8 . W4, BL V . PL at W8 Overall satisfaction 30.12*** 0.354 (L) 0.90 0.012 (S) 4.59* 0.065 (M) 0.686 W8 . W4, BL V . PL at W8 Mean score 34.43*** 0.343 (L) 0.72 0.010 (S) 7.23** 0.100 (M) 0.659 W8 . W4, BL V . PL at W8 Degrees of freedom (1, 66) (1, 66) (1, 66) F η2 (EF) F η2 (EF) F η2 (EF) Beck depression inventory 11.82** 0.182 (L) 0.77 0.001 (S) 9.07** 0.131 (M) 1.00 – – Notes: * = P,0.05; ** = P,0.01; *** = P,0.001. “W8 . W4, BL” indicates that all values at week 8 were statistically higher than the values at week 4 and at baseline. “V . PL at W8” indicates that at week 8, values of the verum group were statistically higher than the values of the placebo group. Abbreviations: EF, effect size; S, small effect size; M, medium effect size; L, large effect size; W8, week 8; W4, week 4; BL, baseline; V, verum; PL, placebo.          %DVHOLQH :HHN 7LPHSRLQWV 6H[XDOIXQFWLRQ :HHN HQGRIVWXG\ 9HUXP 3ODFHER Figure 2 Comparison of sexual function between verum and placebo groups. Notes: Over time, sexual dysfunction improved significantly more in the verum (Rosa damascena oil) group than in the placebo group. Points are means, and bars are standard errors.     %',VFRUHV 7LPHSRLQWV    %DVHOLQH :HHNHQGRIVWXG\ 9HUXP 3ODFHER Figure 3 Comparison of BDI scores between verum and placebo groups. Notes: Over time, symptoms of depression (BDI scores) decreased significantly more in the verum (Rosa damascena extract) group than in the placebo group. Points are means, and bars are standard deviations. Abbreviation: BDI, Beck Depression Inventory.