Paper Title
Comparative Effectiveness of Antidepressant Medication Versus Psychological Treatment of Depressive Symptoms in Infertile Women Suffering Sexual Dysfunction: A Randomized Clinical Controlled Trial

Abstract
Background: Loss of fertility is a challenging experience. The present study was conducted to compare the effectiveness antidepressant medication versus psychological treatment of depressive symptoms in infertile women suffering sexual dysfunction (SD). Materials and Methods: A randomized controlled clinical trial was completed from December 2014 to June 2015 in Babol, Iran. Of the 485 participants, 93 patients were randomly assigned in a 1:1:1 ratio to psychosexual therapy (PST), bupropion extended-released 150 mg per day (BUP ER), and control (no intervention) groups. The Beck depression inventory (BDI) was completed at baseline and end of study (After eight weeks). Statistical analyses were done using paired-test and Analysis of covariance. Results: The mean BDI score of participants was 22.35 ± 8.70 at baseline. Mean BDI score decreased significantly in each treatment group (PST: P <0.0001; BUP: P < 0.002) from baseline to end of the study, whereas intra-individual changes in BDI score were not significant in the control group. The decrease in mean BDI score was greater with PST compared to BUP treatment (P<0.005) and the control group (P<0.0001). A decrease in BDI depression level from baseline to end of study (severe to moderate, moderate to mild) was showed more in PST group than other group(P<0.001). Bupropion extended-released is well tolerated. Conclusions: PST can be a reliable alternative to BUP ER for relieving depression symptoms in infertile women with SD. Keywords - Infertility, depression, psychotherapy, sexual dysfunction, Bupropion.