Antidepressant-Induced Sexual Side Effects: Incidence, Assessment, Clinical Implications, and Management

Francois, Dimitry; Levin, Aaron; Kutscher, Eric; Asemota, Babatunde

doi:10.3928/00485713-20170201-01

Cited by 19 publications

(31 citation statements)

References 51 publications

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“…Antidepressant‐induced sexual dysfunction affects all phases of sexual activity, including desire, arousal and orgasm, in both men and women . The most commonly reported adverse sexual effects in women taking antidepressants are problems with sexual desire (72%), sexual arousal (83%) and orgasm (42%) .…”

Section: Symptoms Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

“…The pathophysiology of sexual dysfunction is complex and poorly understood . Serotonin, noradrenaline, dopamine and acetylcholine all have effects on both the brain and genitalia.…”

Section: Mechanism For Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

“…Other causes or contributors to sexual dysfunction include the depression itself, alcohol use, diabetes, atherosclerosis, cardiac disease, and central and peripheral nervous system conditions. Other medications could also be associated with changes in sexual response (eg, antipsychotics, lithium, mood stabilisers, diuretics, β‐blockers) …”

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

“…In a descriptive study of 344 patients taking an SSRI, 30 patients underwent a dose reduction (by 50%), resulting in sexual dysfunction improvement to some extent in 73% of patients . Evidence for this approach is limited and reducing doses may result in decline of the condition being treated . This approach could be considered if the condition being treated is well controlled, particularly if patients are taking high antidepressant doses and/or have other adverse effects .…”

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

“…Planning sexual activities around times when serum drug levels are at their lowest, such as shortly before a dose or immediately after taking a medication, may be effective for some patients taking antidepressants with short half‐lives . Evidence for this is approach is lacking …”

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

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Antidepressant‐induced sexual dysfunction

Rothmore

2020

Medical Journal of Australia

132

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S exual dysfunction can be subdivided into disorders of sexual drive (usually loss of libido), disorders of arousal and disorders of orgasm and ejaculation, as well as other problems including dyspareunia and priapism. 1 An extensive literature search was undertaken to explore the evidence about antidepressant-induced sexual dysfunction. This included an online search of the MEDLINE, EMBASE, PubMed and Cochrane databases, along with relevant websites and texts and reference lists from identified articles.

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Section: Symptoms Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

“…The pathophysiology of sexual dysfunction is complex and poorly understood . Serotonin, noradrenaline, dopamine and acetylcholine all have effects on both the brain and genitalia.…”

Section: Mechanism For Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

Section: Management Of Antidepressant‐induced Sexual Dysfunctionmentioning

confidence: 99%

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Antidepressant‐induced sexual dysfunction

Rothmore

2020

Medical Journal of Australia

132

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Depression and Anxiety Disorders

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Depression is widely recognised as a major public health problem around the world. The basic principles of prescribing are described in this chapter, along with a summary of NICE guidance. This chapter concentrates on the use of antidepressants and offers advice on drug choice, dosing, switching strategies and sequencing of treatments. Management of treatment‐resistant depression has been informed by the STAR*D programme. The 2019 PANDA trial results support the prescription of selective serotonin reuptake inhibitor antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder. Over the last two decades, ketamine, an uncompetitive N‐Methyl‐D‐Aspartate receptor antagonist and dissociative anaesthetic, has emerged as a novel and effective rapid‐acting antidepressant. Psychotic depression is an under‐identified disorder and may have a life‐time risk of up to 1%.

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Improvement of sexual functioning during treatment of MDD with adjunctive pimavanserin: A secondary analysis

et al. 2020

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Background: Sexual dysfunction is common among patients with major depressive disorder (MDD). In the CLARITY study, the safety and efficacy of adjunctive pimavanserin, an inverse agonist at 5-HT 2A receptors, were demonstrated when added to existing treatment for MDD. This analysis provides a detailed assessment of the effects of pimavanserin on sexual function from the CLARITY study. Methods: Patients with a diagnosis of MDD in a depressive episode, inadequate response to ongoing antidepressant therapy, and a Montgomery-Åsberg Depression Rating Scale total score >20 were randomized to pimavanserin 34 mg/day or placebo added to ongoing treatment with an immediate revision of all selective serotonin or serotonin-norepinephrine for 5 weeks (Stage 1), and nonresponders (<50% improvement from baseline in Hamilton Depression Rating Scale [HAMD-17]) were re-randomized for an additional 5 week (Stage 2). Effects of pimavanserin on the Massachusetts General Hospital Sexual Functioning Index (MGH-SFI) and HAMD-17 Item 14 (sexual interest) were examined. Results: Among 203 patients (51 on pimavanserin; 152 on placebo), pimavanserin demonstrated significant improvement from baseline to Week 5 on the MGH-SFI (least square [LS]mean difference −0.634, 95% confidence interval [CI] [−0.964, −0.304]; p = .0002; effect size [ES], Cohen's d: .614). Across Stages 1 and 2, the weighted LSmean difference was −0.468 (95% CI [−0.720, −0.216]; p = .0003) for pimavanserin versus placebo. Mean changes from baseline to Week 5 for MGH-SFI Items 1, 2, 3, and 5 and HAMD Item 14 were significantly (p < .05) greater with pimavanserin versus placebo. Conclusions: Adjunctive pimavanserin improved sexual function in patients with MDD. Adding pimavanserin to ongoing treatment for MDD may be especially useful for patients experiencing sexual dysfunction. K E Y W O R D S adjunctive, major depressive disorder, pimavanserin, sexual function

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Antidepressant-Induced Sexual Side Effects: Incidence, Assessment, Clinical Implications, and Management

Abstract: ABSTRACT

Cited by 19 publications

References 51 publications

Antidepressant‐induced sexual dysfunction

Antidepressant‐induced sexual dysfunction

Depression and Anxiety Disorders

Improvement of sexual functioning during treatment of MDD with adjunctive pimavanserin: A secondary analysis

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