Antidepressant-associated Sexual Dysfunction: Impact, Effects, and Treatment

Overview

Journal Drug Healthc Patient Saf

Publisher Dove Medical Press

Specialty Health Services

Date 2011 Jun 25

PMID 21701626

Citations 48

Authors

Agnes Higgins

Michael Nash

Aileen M Lynch

Affiliations

Soon will be listed here.

Abstract

Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person's quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women. The focus of this article is to explore the incidence, pathophysiology, and treatment of antidepressant iatrogenic sexual dysfunction.

Citing Articles

Management of vasomotor symptoms in cancer patients.

Zhu L, Hshieh T, Iyer T, Morgans A, Hamnvik O Oncologist. 2025; 30(2).

PMID: 40037618 PMC: 11879400. DOI: 10.1093/oncolo/oyaf002.

The Potential Protective Role of Ascorbic Acid Against Testicular Toxicity Induced by Fluoxetine in Male Wistar Rats.

Aruwa J, Bisong S, Obeten K, Etukudo E, Timothy N, Kureh T J Exp Pharmacol. 2024; 16:441-453.

PMID: 39605962 PMC: 11600935. DOI: 10.2147/JEP.S476773.

The value of PROMs for predicting erectile dysfunction in prostate cancer patients with Bayesian network.

Osong B, Hasannejadasl H, van der Poel H, Vanneste B, van Roermund J, Aben K Tech Innov Patient Support Radiat Oncol. 2024; 31:100234.

PMID: 39188594 PMC: 11345401. DOI: 10.1016/j.tipsro.2024.100234.

In vitro effects of antidepressants on human sperm function.

Santos R, Sousa A, Almeida-Santos T, Ramalho-Santos J, Tavares R Asian J Androl. 2024; 27(1):30-36.

PMID: 39136628 PMC: 11784965. DOI: 10.4103/aja202459.

Combination of low doses of mirtazapine plus venlafaxine produces antidepressant-like effects in rats, without affecting male or female sexual behavior.

Alvarez-Silva A, Rodriguez-Manzo G, Reyes R, Fernandez-Guasti A Psychopharmacology (Berl). 2024; 242(1):189-204.

PMID: 39107588 PMC: 11742888. DOI: 10.1007/s00213-024-06661-2.

References

Clayton A, Pradko J, Croft H, Montano C, Leadbetter R, Bass K . Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002; 63(4):357-66. DOI: 10.4088/jcp.v63n0414. View

Ekselius L, von Knorring L . Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care. J Clin Psychopharmacol. 2001; 21(2):154-60. DOI: 10.1097/00004714-200104000-00006. View

Kennedy S, Eisfeld B, Dickens S, Bacchiochi J, Bagby R . Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 2000; 61(4):276-81. DOI: 10.4088/jcp.v61n0406. View

Rothschild A . Sexual side effects of antidepressants. J Clin Psychiatry. 2000; 61 Suppl 11:28-36. View

COLEMAN C, King B, Book M, Segraves R, Richard N, ASCHER J . A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine. Clin Ther. 2001; 23(7):1040-58. DOI: 10.1016/s0149-2918(01)80090-4. View

Ahmad S . Paroxetine-induced priapism. Arch Intern Med. 1995; 155(6):645. View

Labbate L, Croft H, Oleshansky M . Antidepressant-related erectile dysfunction: management via avoidance, switching antidepressants, antidotes, and adaptation. J Clin Psychiatry. 2003; 64 Suppl 10:11-9. View

Clayton A, Keller A, McGarvey E . Burden of phase-specific sexual dysfunction with SSRIs. J Affect Disord. 2006; 91(1):27-32. DOI: 10.1016/j.jad.2005.12.007. View

Tanrikut C, Schlegel P . Antidepressant-associated changes in semen parameters. Urology. 2007; 69(1):185.e5-7. DOI: 10.1016/j.urology.2006.10.034. View

10.

Modell J, Katholi C, Modell J, DePalma R . Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther. 1997; 61(4):476-87. DOI: 10.1016/S0009-9236(97)90198-3. View

11.

Leiblum S, Goldmeier D . Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal. J Sex Marital Ther. 2008; 34(2):150-9. DOI: 10.1080/00926230701636205. View

12.

Yamada M, Yamada M, Higuchi T . Antidepressant-elicited changes in gene expression: remodeling of neuronal circuits as a new hypothesis for drug efficacy. Prog Neuropsychopharmacol Biol Psychiatry. 2005; 29(6):999-1009. DOI: 10.1016/j.pnpbp.2005.03.022. View

13.

Watson J, Davies T . ABC of mental health. Psychosexual problems. BMJ. 1997; 315(7102):239-42. PMC: 2127153. DOI: 10.1136/bmj.315.7102.239. View

14.

Nelson E, Shah V, Welge J, Keck Jr P . A placebo-controlled, crossover trial of granisetron in SRI-induced sexual dysfunction. J Clin Psychiatry. 2001; 62(6):469-73. DOI: 10.4088/jcp.v62n0611. View

15.

Kennedy S, Dickens S, Eisfeld B, Bagby R . Sexual dysfunction before antidepressant therapy in major depression. J Affect Disord. 2000; 56(2-3):201-8. DOI: 10.1016/s0165-0327(99)00050-6. View

16.

Keltner N, McAfee K, Taylor C . Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspect Psychiatr Care. 2002; 38(3):111-6. View

17.

Higgins A, Barker P, Begley C . 'Veiling sexualities': a grounded theory of mental health nurses responses to issues of sexuality. J Adv Nurs. 2008; 62(3):307-17. DOI: 10.1111/j.1365-2648.2007.04586.x. View

18.

Demyttenaere K, Huygens R . Painful ejaculation and urinary hesitancy in association with antidepressant therapy: relief with tamsulosin. Eur Neuropsychopharmacol. 2002; 12(4):337-41. DOI: 10.1016/s0924-977x(02)00040-8. View

19.

OFlynn R, Michael A . Reboxetine-induced spontaneous ejaculation. Br J Psychiatry. 2000; 177:567-8. DOI: 10.1192/bjp.177.6.567-b. View

20.

Frohlich P, Meston C . Evidence that serotonin affects female sexual functioning via peripheral mechanisms. Physiol Behav. 2001; 71(3-4):383-93. DOI: 10.1016/s0031-9384(00)00344-9. View