Antidepressant-associated sexual dysfunction: impact, effects, and treatment

Abstract

Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person’s quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women. The focus of this article is to explore the incidence, pathophysiology, and treatment of antidepressant iatrogenic sexual dysfunction.

Sexual Dysfunction, Depression and Antidepressants: A Translational Approach

“…Major depression is often associated with sexual dysfunctions [2,3]. Treatment of the depression with antidepressants complicates the situation considerably.…”

Dose Dependent Amitriptyline Induced Sexual Dysfunction in a Migraine Patient

“…Studies have found that increased central serotonergic activity is involved in causing sexual dysfunction. [5] Studies have shown that amitriptyline use in migraine is associated with adverse effects like weight gain, constipation, blurring of vision, dryness of mouth, etc. But it is rarely reported that its use is associated with sexual dysfunction as an adverse effect in the treatment of migraine.…”

“…It can have significant impact on the person's quality of life, quality of relationships and selfesteem. [5] Hence a regular monitoring of adverse reactions in patients who are on long term drugs is needed. Since most of these adverse effects are reversible, it is important…”

“…[4] Drug-induced sexual dysfunction is a problem which occurs during the treatment of various illnesses like depression, hypertension and diabetes mellitus. [5] Drugs which are reported to cause sexual dysfunction are antidepressants like amoxapine, trazodone, antihypertensives like hydrochlorthiazide, spironolactone, [6] methyldopa, and antipsychotics like chlorpromazine, haloperidol, etc. [7] Sexual dysfunction is categorized into main phases like decreased libido, priapism, impotence or erectile dysfunction and delayed ejaculation.…”

“…[7] Sexual dysfunction is categorized into main phases like decreased libido, priapism, impotence or erectile dysfunction and delayed ejaculation. [5] Etiology of erectile dysfunction may be vascular, hormonal, neurologic, drug induced or psychogenic. [8] Studies have shown that amitriptyline use in migraine is associated with adverse effects like weight gain, constipation, blurring of vision, dryness of mouth etc.…”