Sexual side effects of antidepressants

Patients with depressive disorders frequently have concurrent sexual proble ms. The sexual dysfunction is often masked by the mood disorder, and many p atients have difficulty discussing these problems openly. Thus, sexual dysf unction often is detectable only by careful inquiry. The relationship betwe en sexual dysfunction and depressive disorders is further complicated by an tidepressant therapy, which itself may cause sexual dysfunction, increasing the risk of noncompliance and relapse. This article reviews studies indica ting that antidepressants may cause 30% to 40% of patients who take them to develop some degree of sexual dysfunction. Management strategics for allev iating sexual dysfunction as a complication of antidepressant treatment are discussed in terms of supporting research studies as well as practicality. Spontaneous resolution of antidepressant-induced sexual dysfunctions rarel y occurs, and dose reductions may jeopardize the antidepressant effect. Ant idotes, drug holidays, and timing sexual relations with respect to antidepr essant dose are effective for some patients, but only a few of these strate gies have been studied with double-blind paradigms. Switching to antidepres sants that cause sexual dysfunction at lower rates and data comparing rates of sexual dysfunction among antidepressants are discussed.