Depression and SD have a bidirectional association. When screening for depression, baseline sexual functioning should be assessed with validated rating scales. If sexual side effects develop with antidepressant treatment, management options include waiting for spontaneous remission, decreasing the medication dose, switching to an alternative drug or adding an augmentation agent or antidote. Research suggests that bupropion and newer antidepressants exhibit a more favorable SD profile compared with other antidepressants, especially selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors. Bupropion, mirtazapine and buspirone have been studied as augmentation agents/antidotes or substitution agents in management of AASD. Future studies validating genetic factors could enable personal genotyping to guide individualized treatment and also facilitate the development of enhanced therapeutic guidelines to avoid or manage AASD.
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