USE OF PSYCHOACTIVE AGENTS IN THE TREATMENT OF SEXUAL DYSFUNCTION

Sexual function can be subdivided into phases of sexual desire, penile erection, ejaculation and orgasm. Dysfunction of these processes is m anifest as disorders that include hypoactive sexual desire, male erect ile dysfunction, premature and retarded ejaculation, and anorgasmia, T hese disorders can be primary in aetiology or can be caused by a numbe r of psychoactive drugs including, commonly, antidepressants. At prese nt, sexual dysfunction is rarely treated with pharmacological agents. The usual approach consists of psychotherapy. However, in recent years , more interest has arisen in treating disorders of sexual function wi th psychopharmacological drugs, particularly sexual dysfunction that i s the adverse effect of antidepressants. Clinical reports suggest that primary premature ejaculation can be successfully treated with clomip ramine and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake in hibitors. At present, only a few oral medications have been shown to b e useful in the treatment of erectile dysfunction (including yohimbine and trazodone), although these have not been developed specifically f or this indication. The pharmacological treatment of primary retarded ejaculation and female primary anorgasmia still offers no efficacy-The re are, on the other hand, a number of drugs available for treating th e sexual adverse effects of antidepressant therapy. These appear to ac t either on the central or peripheral nervous system and include cypro heptadine, bethanechol, yohimbine, buspirone and some dopamine recepto r agonists [amantadine, amfebutamone (bupropion), dexamphetamine and p emoline]. More methodologically correct clinical research is necessary to elucidate better treatments for sexual dysfunction.