Antidepressant-Induced Sexual Side Effects: Incidence, Assessment, Clinical Implications, and Management

Antidepressant medications can cause numerous types of sexual dysfunction. It is important to screen for and treat antidepressant-induced sexual dysfunction, which is often under-reported and may exacerbate mood symptoms and negatively affect relationships and medication adherence. Management strategies include watchful waiting, reducing the antidepressant dose, adding a different type of antidepressant or a medication for erectile dysfunction, switching to another antidepressant, drug holidays, and timing of sexual relations with respect to antidepressant dose. [Psychiatr Ann. 2017;47(3):154-160.] Sexual dysfunction (SD) is a problem among patients with depression, affecting almost one-half of people with untreated depression.1 Whereas 26% of nondepressed people report some sexual dysfunction, this number increases to 45% in people with untreated depression, and to 63% in medically treated patients with depression.2 In addition to high levels of baseline SD in patients with depression, many antidepressant medications independently cause SD in any or all phases of the sexual response cycle, including libido, arousal, orgasm, and ejaculation.1 TYPES OF ANTIDEPRESSANTINDUCED SEXUAL SIDE EFFECTS Antidepressants can cause a variety of types of sexual dysfunction. In a hallmark study by Montejo-Gonzalez et al.,3 decreased libido was seen in Dimitry Francois, MD, FAPA, is an Assistant Professor of Psychiatry; the Associate Director, Psychiatry Clerkship; and the Site Director, Psychiatry Clerkship (Westchester), Weill Cornell Medicine. Ariana Mireille Levin, BS, is a secondyear Medical Student, Weill Cornell Medicine. Eric J. Kutscher, BA, is a second-year Medical Student, Weill Cornell Medicine. Babatunde Asemota, MBBS, is an Assistant Professor of Clinical Psychiatry, Weill Cornell Medicine; and an Assistant Attending Psychiatrist, New York– Presbyterian Hospital Westchester Division. Address correspondence to Dimitry Francois, MD, FAPA, Weill Cornell Medicine, New York–Presbyterian/Westchester, 21 Bloomingdale Road, White Plains, NY 10605; email: [email protected]. Disclosure: The authors have no relevant financial relationships to disclose. doi: 10.3928/00485713-20170201-01 © S hu tte rs to ck