Premium
Antidepressant‐induced sexual dysfunction
Author(s) -
Rothmore Jody
Publication year - 2020
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.50522
Subject(s) - mirtazapine , sexual dysfunction , bupropion , antidepressant , clomipramine , nefazodone , moclobemide , adverse effect , discontinuation , escitalopram , medicine , reuptake inhibitor , psychology , reboxetine , tricyclic , sexual function , fluoxetine , psychiatry , pharmacology , serotonin , anxiety , receptor , pathology , smoking cessation
Summary Sexual dysfunction is a frequent, potentially distressing, adverse effect of antidepressants and a leading cause of medication non‐adherence. Sexual function should be actively assessed at baseline, at regular intervals during treatment, and after treatment cessation. Trials comparing the risk of sexual dysfunction with individual antidepressants are inadequate, but it is reasonable to conclude that the risk is greatest with selective serotonin reuptake inhibitors ( SSRI s) and serotonin and noradrenaline reuptake inhibitors ( SNRI s), less with tricyclic antidepressants (except clomipramine) and mirtazapine, and least with moclobemide, agomelatine, reboxetine and bupropion. Management of antidepressant‐induced sexual dysfunction requires an individualised approach (eg, considering other causes, dose reduction, addition of medication to treat the adverse effect, switching to a different antidepressant). Post‐ SSRI sexual dysfunction has been recently identified as a potential, although rare, adverse effect of SSRI s and SNRI s. Consider the possibility of post‐ SSRI sexual dysfunction in patients in whom sexual dysfunction was absent before starting antidepressants but develops during or soon after antidepressant treatment and still persists after remission from depression and discontinuation of the drug.