Sexual Functioning and SSRIs

This article reviews the literature concerning the relationship between sexual functioning and selectiveserotonin reuptake inhibitors (SSRIs). Reduced sexual functioning is a common depressivesymptom that typically improves after successful antidepressant treatment. On the other hand, sexualdysfunction has been observed in a substantial proportion of patients treated with all classes of antidepressants.In particular, SSRI use has been shown to be associated with sexual dysfunction. A numberof pharmacologic interventions have been found to be helpful in anecdotal case reports. Unfortunately,the lack of placebo-controlled studies in this area limits our ability to draw firm conclusions onthe efficacy of such interventions. Three classes of drugs have primarily been used to counteractsexual side effects of SSRIs: serotonin receptor antagonists, α₂-adrenergic receptor antagonists, anddopaminergic agents. An open trial from our group suggests the potential usefulness of oral sildenafilin the treatment of antidepressant-associated sexual side effects, but further studies are needed.