SELECTIVE SEROTONIN REUPTAKE INHIBITOR-INDUCED SEXUAL DYSFUNCTION - CLINICAL AND RESEARCH CONSIDERATIONS

Antidepressants, including the tricyclic antidepressants, monoamine ox idase inhibitors (MAOIs) and selective serotonin reuptake inhibitors ( SSRIs), cause sexual dysfunctions such as decreased sexual desire, ere ctile difficulties and delayed ejaculation. Such sexual side-effects a ffect quality of life and may result in non-compliance with medication and the associated risk of recurrence of depression. Depression may a lso be associated with sexual disturbances, especially reduced libido. It is important to unravel the origin of sexual problems during depre ssion and determine whether they were present before depression starte d, whether they are associated with the depression, or whether they ar e an effect of medication. Baseline measurements, objective measures a nd accurate instruments are all essential for scientific research into the sexual side-effects of antidepressants. Various human factors tha t may influence measurements of sexual behaviour must also be taken in to account. Considering all these provisos, the ejaculation delaying e ffects of the SSRIs (fluvoxamine, fluoxetine, paroxetine and sertralin e) have been investigated in a double-blind, placebo-controlled study in men with rapid ejaculation. The SSRIs were given at their recommend ed daily dosages for 6 weeks and the men measured their intravaginal e jaculation latency time at home using a stopwatch. The results showed a clear difference between the SSRIs, fluvoxamine having by far the le ast disturbing effect on ejaculation, Int Clin Psychopharmacol 13 (sup pl 6)S27-S33 (C) Lippincott-Raven Publishers.