Medical Journal of The Islamic Republic of Iran (MJIRI)

Background: Sexual dysfunction is a Prevalent and distressing adverse effect of selective serotonin reuptake inhibitors (SSRIs) and frequently leads to poor treatment adherence and medication discontinuation. Cinnamomum Tamala has traditionally been used in Persian medicine as an aphrodisiac. This study aimed to assess the efficacy and safety of C. Tamala as a complementary treatment for SSRI-induced sexual dysfunction in women.
   Methods: This was an 8-weeks parallel-group, double-blind, randomized, placebo-controlled trial conducted at outpatient psychiatry clinics affiliated with Iran University of Medical Sciences between September 2024 and February 2025. Fifty-eight married women aged 18–45 years receiving stable SSRI therapy and reporting decreased libido were randomly assigned in a 1:1 allocation ratio to receive either C. Tamala capsules (1000 mg/day) or placebo. The primary endpoint was the change in the total Arizona Sexual Experience Scale (ASEX) score from baseline to week 8. Between-group analyses were performed using ANCOVA adjusted for baseline ASEX scores.
   Results: Forty-eight participants completed this study (23 in the C. Tamala group and 25 in the placebo group). Baseline ASEX total scores were comparable between groups (26.70 ± 4.52 vs. 28.20 ± 3.19; *P* = 0.134). After 8 weeks, the C. Tamala group demonstrated Significantly better improvement in total ASEX score compared with placebo (mean change: -8.26 ± 6.13 vs. -1.28 ± 2.59; adjusted mean difference: -7.11; 95% CI: -9.88 to -4.34; P < 0.001). The effect size was large (Cohen's d = 1.53, 95% CI: 0.94 to 2.12). Sensitivity intention-to-treat analysis using multiple imputations yielded consistent Findings (adjusted mean difference −6.70; 95% CI −8.39 to −5.01; P < 0.001). No serious adverse events occurred.
   Conclusion: Adjunctive treatment with Cinnamomum Tamala (1000 mg/day for 8 weeks) significantly improved SSRI-induced sexual dysfunction in women with acceptable tolerability.