Sexual Dysfunction Due to Psychotropic Medications

Clayton, Anita H.; Alkis, Andrew R.; Parikh, Nishant B.; Votta, Jennifer G.

doi:10.1016/j.psc.2016.04.006

Cited by 63 publications

(49 citation statements)

References 183 publications

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“…In the case of serotonergic antidepressants (SSRIS), sexual dysfunction, a relevant but almost unnoticed adverse effect in clinical trials, has been subsequently identified by patients and clinicians as the most frequent adverse effect in the medium and long term. Unfortunately, its frequency remains highly under rated (5-15%) when compared with clinical practice epidemiological data (50-70%) (Clayton et al, 2016;Montejo et al, 2018Montejo et al, , 2019.…”

Section: Safety and Tolerability Of Psychotropic Compoundsmentioning

confidence: 99%

Editorial: Safety and Tolerability of Psychotropic Compounds

Montejo

Lourenço

2020

Front. Neurosci.

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Section: Safety and Tolerability Of Psychotropic Compoundsmentioning

confidence: 99%

Editorial: Safety and Tolerability of Psychotropic Compounds

Montejo

Lourenço

2020

Front. Neurosci.

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“…One example is sexual dysfunction, which affects patients’ quality of life and continuity of treatment [9,10,11,12,13]. The incidence of sexual dysfunction is high (50–70%) when the mechanism of action is blocking serotonin reuptake, whereas drugs that act preferably on noradrenaline or dopamine reuptake have a less negative impact on the sexual function [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Mechanism of Antidepressant-Related Sexual Dysfunction: Inhibition of Tyrosine Hydroxylase in Dopaminergic Neurons after Treatment with Paroxetine but Not with Agomelatine in Male Rats

Santana

Montejo

Martín

et al. 2019

JCM

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Antidepressant-related sexual dysfunction is a frequent adverse event caused by serotonergic activation that intensely affects quality of life and adherence in depressed patients. The dopamine system has multiple effects promoting sexual behavior, but no studies have been carried out to confirm dopaminergic changes involved in animal models after antidepressant use. Methods: The sexual behavior-related dopaminergic system in the rat was studied by comparing two different antidepressants and placebo for 28 days. The antidepressants used were paroxetine (a serotonergic antidepressant that causes highly frequent sexual dysfunction in humans) and agomelatine (a non-serotonergic antidepressant without associated sexual dysfunction). The tyrosine hydroxylase immunoreactivity (THI) in the substantia nigra pars compacta, the ventral tegmental area, the zona incerta, and the hypothalamic arcuate nucleus, as well as the dopaminergic projections to the striatum, hippocampus, cortex, and median eminence were analyzed. Results: The THI decreased significantly in the substantia nigra and ventral tegmental area after treatment with paroxetine, and the labeling was reduced drastically in the zona incerta and mediobasal hypothalamus. The immunoreactive axons in the target regions (striatum, cortex, hippocampus, and median eminence) almost disappeared only in the paroxetine-treated rats. Conversely, after treatment with agomelatine, a moderate reduction in immunoreactivity in the substantia nigra was found without appreciable modifications in the ventral tegmental area, zona incerta, and mediobasal hypothalamus. Nevertheless, no sexual or copulatory behavior was observed in any of the experimental or control groups. Conclusion: Paroxetine but not agomelatine was associated with important decreased activity in dopaminergic areas such as the substantia nigra and ventral tegmental areas that could be associated with sexual performance impairment in humans after antidepressant treatment.

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“…The same patients are also likely to receive medications for MDD or for other medical conditions, and to take supplements and medications for wellness, such as oral contraceptives. It is then apparent that multiple causes of sexual dysfunction can coexist, such as psychiatric disorders, other medical conditions, and pharmacotherapy [7], whether medications are prescribed for the treatment of the same medical disorders or taken for wellness. Our sample of patients with sexual dysfunction-which we hereby report on-exemplifies the multifactorial nature of causality of sexual dysfunction.…”

Section: Introductionmentioning

confidence: 99%