Sexual Side Effects of Antidepressants
Anthony J. Rothschild, MD
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Patients with depressive disorders frequently have concurrent sexual problems. The sexual dysfunction
is often masked by the mood disorder, and many patients have difficulty discussing these
problems openly. Thus, sexual dysfunction often is detectable only by careful inquiry. The relationship
between sexual dysfunction and depressive disorders is further complicated by antidepressant
therapy, 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 who
take them to develop some degree of sexual dysfunction. Management strategies for alleviating sexual
dysfunction as a complication of antidepressant treatment are discussed in terms of supporting research
studies as well as practicality. Spontaneous resolution of antidepressant-induced sexual dysfunctions
rarely occurs, and dose reductions may jeopardize the antidepressant effect. Antidotes, drug
holidays, 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 to
antidepressants that cause sexual dysfunction at lower rates and data comparing rates of sexual dysfunction
among antidepressants are discussed.
J Clin Psychiatry 2000;61(suppl 11):28-36
© Copyright 2000 Physicians Postgraduate Press, Inc.
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