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Physiol Int. 2019 Mar 1;106(1):59-69. doi: 10.1556/2060.106.2019.02. Epub 2019 Mar 19.

Pycnogenol supplementation as an adjunct treatment for antidepressant-induced sexual dysfunction.

Author information

1 Outpatient Psychiatric Clinic , Bojnice, Slovakia.
2 Faculty of Medicine, Comenius University in Bratislava , Bratislava, Slovakia.
3 Biomedical Center Martin, Division of Neurosciences, Jessenius Faculty of Medicine in Martin, Department of Physiology JFM CU, Comenius University in Bratislava (JFM CU) , Martin, Slovakia.
4 Department of Nursing, Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia.
5 Department of Physiology, Jessenius Faculty of Medicine in Martin, Biomedical Center Martin JFM CU, Comenius University in Bratislava (JFM CU) , Martin, Slovakia.
6 Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin , Bratislava, Slovakia.



Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is associated with incidence of adverse events, such as constipation, diarrhea, dry mouth, headache, insomnia, and sexual dysfunction (SDys). Escitalopram (ESC), an effective and safe selective serotonin reuptake inhibitor with good tolerability, was used in this study. In this study, we investigated the prospective effect of Pycnogenol (PYC), an antioxidant, anti-inflammatory, and vasodilator agent, on ESC-induced SDys.


This was a randomized, parallel, open-label study. Seventy-two outpatients of both genders with depression were randomized into two groups as follows: 37 patients from the ESC + PYC group took 50 mg of PYC per day for 4 months in ESC co-treatment, and 35 subjects from the ESC group took ESC only. Five patients dropped out and were excluded from the analysis. The participants were examined every month (visits 1-4).


ESC use led to improvement of depressive symptoms and severity scored by standardized psychiatric tests. PYC co-treatment resulted in attenuation of SDys beginning at 1 month of treatment and continuing for two consecutive months. Furthermore, an increase in heart rate in the PYC group was registered.


We propose that PYC-mediated SDys attenuation is based on its ability to improve endothelial functions by its antioxidant, anti-inflammatory, vasodilatory, and anticoagulant action. We assume that the action of PYC on heart rate is in accordance with the aforementioned vasodilatory action of PYC and consequent baroreflex-mediated heart rate response. PYC co-treatment reduced ESC-induced SDys and elevated heart rate.


Pycnogenol; depression; escitalopram; heart rate; sexual dysfunction

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