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Feature Article
Antidepressant-Induced Sexual
Side Efects: Incidence, Assessment,
Clinical Implications, and Management
Dimitry Francois, MD, FAPA; Ariana Mireille Levin, BS; Eric J. Kutscher, BA;
and Babatunde Asemota, MBBS
ABSTRACT
Antidepressant medications can cause
numerous types of sexual dysfunction. It is
important to screen for and treat antidepres-
sant-induced sexual dysfunction, which is
often under-reported and may exacerbate
mood symptoms and negatively afect
relationships and medication adherence.
Management strategies include watchful
waiting, reducing the antidepressant dose,
adding a diferent type of antidepressant
or a medication for erectile dysfunction,
switching to another antidepressant, drug
holidays, and timing of sexual relations with
respect to antidepressant dose. [Psychiatr
Ann. 2017;47(3):154-160.]
S
exual dysfunction (SD) is a
problem among patients with
depression, affecting almost
one-half of people with untreated
depression.
1
Whereas 26% of non-
depressed people report some sexual
dysfunction, this number increases to
45% in people with untreated depres-
sion, and to 63% in medically treated
patients with depression.
2
In addition
to high levels of baseline SD in pa-
tients with depression, many antide-
pressant medications independently
cause SD in any or all phases of the
sexual response cycle, including libi-
do, arousal, orgasm, and ejaculation.
1
TYPES OF ANTIDEPRESSANT-
INDUCED SEXUAL SIDE EFFECTS
Antidepressants can cause a variety
of types of sexual dysfunction. In a
hallmark study by Montejo-Gonzalez
et al.,
3
decreased libido was seen in
Dimitry Francois, MD, FAPA, is an Assistant
Professor of Psychiatry; the Associate Director,
Psychiatry Clerkship; and the Site Director, Psy-
chiatry Clerkship (Westchester), Weill Cornell
Medicine. Ariana Mireille Levin, BS, is a second-
year Medical Student, Weill Cornell Medicine.
Eric J. Kutscher, BA, is a second-year Medical
Student, Weill Cornell Medicine. Babatunde
Asemota, MBBS, is an Assistant Professor of
Clinical Psychiatry, Weill Cornell Medicine; and
an Assistant Attending Psychiatrist, New York–
Presbyterian Hospital Westchester Division.
Address correspondence to Dimitry
Francois, MD, FAPA, Weill Cornell Medicine,
New York–Presbyterian/Westchester, 21
Bloomingdale Road, White Plains, NY 10605;
email: dif9013@med.cornell.edu.
Disclosure: The authors have no relevant
financial relationships to disclose.
doi: 10.3928/00485713-20170201-01
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