Andreev, who won his hometown event in 2005, broke twice to win the first set. But Seppi, ranked 53rd, made one break in the second set and one more early in the third to serve for the match at 1-1 and 5-4 up. But the Russian broke back to force a tiebreaker.
"A tiebreaker is always a lottery," said Andreev. "I made a couple of mistakes, then narrowed the gap to 5-4 down but luck was on his side." Andreev, who reached a career high ranking of 18 in 2008, suffers from pain in his knees and has dropped to No. 115 this season. He will decide his future in tennis after a checkup in Germany later this year.
"You cannot beat anyone playing on one leg," he said. Andreev hasn't reach a quarterfinal this season.
Dushevina rallied from 4-0 down in the first set and from 4-2 down in the second, winning four consecutive games to wrap up the match.
"It was a tough match and I was trailing in both sets," Dushevina said. "But I managed to turn my luck." Earlier, Kaia Kanepi of Estonia defeated Italy's Sara Errani 6-0, 7-5 on her debut at the tournament.
In the men's opener, Teymuraz Gabashvili of Russia advanced to the second round with a 6-2, 6-4 victory over Karol Beck of Slovakia.
Elsewhere, Pere Riba of Spain ousted Andreas Haider-Maurer of Austria, 6-2, 6-7 (1), 6-3, while Mikhail Kukushkin of Kazakhstan beat Lukas Rosol of the Czech Republic 7-6 (5), 7-5.
Janko Tipsarevic, runner-up in 2009, heads the men's draw of the 22nd edition of the event. Vera Zvonareva, who won in 2008, tops the women's field.
Zvonareva is among the seven players who have already qualified for next week's season-ending WTA Tour championships in Istanbul.
Second-seeded Agnieszka Radwanska, who won the China Open in Beijing a week ago for her second straight title and third of the season, needs to win just one match in Moscow to secure the last spot in the championships.
Third-seeded Marion Bartoli, who beat Samantha Stosur in the Japan Open final on Sunday, also has a slim chance of qualifying if she wins in Moscow and Radwanska loses her opener.
