DEPRESSION AND SEXUAL FUNCTION

Depressed patients may experience sexual dysfunction either as a conse quence of their depression or of their antidepressant medication, or b oth. Sexual dysfunction may manifest as reduction of desire, impairmen t of arousal, and loss, delay or alteration of orgasm, Estimates of se xual dysfunction in unipolar depressed patients range from 35 to 47%. An increasing body of evidence suggests that antidepressants such as t ricyclic antidepressants and selective serotonin re-uptake inhibitors are associated with 'treatment-emergent' sexual dysfunction in a relat ively high proportion of depressed patients. In clinical trials involv ing > 4000 patients, the serotonin re-uptake inhibitor and 5-HT2 antag onist nefazodone has been associated with a very low incidence of sexu al dysfunction, comparable with that of the placebo group. Treatment a pproaches for sexual dysfunction in depression include reduction in do se or switch of antidepressant medication, adjuvant treatment and/or p sychological and behavioural strategies.