Sexual Side Effects of Antidepressants

Patients with depressive disorders frequently have concurrent sexual problems. The sexual dysfunctionis often masked by the mood disorder, and many patients have difficulty discussing theseproblems openly. Thus, sexual dysfunction often is detectable only by careful inquiry. The relationshipbetween sexual dysfunction and depressive disorders is further complicated by antidepressanttherapy, which itself may cause sexual dysfunction, increasing the risk of noncompliance and relapse.This article reviews studies indicating that antidepressants may cause 30% to 40% of patients whotake them to develop some degree of sexual dysfunction. Management strategies for alleviating sexualdysfunction as a complication of antidepressant treatment are discussed in terms of supporting researchstudies as well as practicality. Spontaneous resolution of antidepressant-induced sexual dysfunctionsrarely occurs, and dose reductions may jeopardize the antidepressant effect. Antidotes, drugholidays, and timing sexual relations with respect to antidepressant dose are effective for some patients,but only a few of these strategies have been studied with double-blind paradigms. Switching toantidepressants that cause sexual dysfunction at lower rates and data comparing rates of sexual dysfunctionamong antidepressants are discussed.