Psychiatria pre prax 3/2003

Antidepressant – indued sexual dysfunction

Risk of antidepressant-induced sexual dysfunctions (SD) is not yet sufficiently explored. According to our present knowledge, agents with mainly serotonergic effect might be associated with higher rates of sexual dysfunctions than antiserotonergic, dopaminergic, and probably noradrenergic drugs. A higher risk of sexual dysfunctions is supposed in a group of tricyclic antidepressants, IMAO, SSRI, and SNRI. In contrast, RIMA (moclobemide), SARI (nefazodone a trazodone), NaSSA (mirtazapine), NARI (reboxetine), NDRI (bupropione), SRE (tianeptine), and St. John’s wort extract (Hypericum perforatum) probably represent a low-risk subgroup. Nefazodone, trazodone and mirtazapine are used as adjunctive treatment for SD. When sexual side effects occur, it is possible to replace a problematic antidepressant with other agent with less sexual dysfunction.

Keywords: antidepressants, drug-induced sexual dysfunctions, prevalence, treatment.