Sexual dysfunction and antidepressants

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Abstract
Antidepressants can interfere with sexual desire, arousal, or orgasm. Frequency estimates vary considerably and are likely to be influenced by methods of assessment, drug type, diagnostic group, dose, length of treatment, baseline depressive status, and inclusion of a placebo condition. Frequency estimates of antidepressant induced sexual dysfunction were reviewed in three sets of data: Physicians' Desk Reference (PDR) product monograph, placebo‐controlled trials, and uncontrolled reports. Rates were lowest in the PDR and highest when a structured rating was used. Among the drug groups, from all those sources, sexual dysfunction was lowest overall with bupropion, moclobemide, and trazodone, intermediate for selective serotonin reuptake inhibitors (SSRIs) and venlafaxine, and highest for tricyclic (TCA) and first generation monoamine oxidase inhibitor (MAOI) drugs. In open, uncontrolled trials, bupropion was associated with disappearance of sexual dysfunction when given to patients who exhibited this side effect from TCA or SSRI drugs. This review suggests that men and women, depressives and non‐depressives, are both at risk for sexual side effects. Currently available sexual function scales are either too complex for routine clinical use, or are limited in scope (e.g., restricted to males only). Availability of a simple, easy to use, analogue‐type scale would facilitate research, and perhaps enhance the use of antidepressant drugs. Depression 2:233–240 (1994/1995).

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