Resulting sexual dysfunction can impair quality of life and intimate relationships and discourage patients from taking antidepressants Box 1 , 2. Although most reports have focused on SSRIs, all antidepressant classes have been associated with sexual dysfunction, with prevalence likely influenced by differences in neurotransmitter modulation Table 2. A recent study reported similarly high rates with mirtazapine, but its small sample size limits conclusions about side effect prevalence with this drug. Clomipramine appears to have the highest rates of sexual dysfunction—particularly anorgasmia—probably because it inhibits the serotonin transporter more than do other TCAs. MAOIs directly increase serotonergic neurotransmission, and their substantial alpha-adrenergic antagonist effects may also produce sexual side effects.
Managing Antidepressant-Induced Sexual Dysfunction: A Holistic Approach
When an SSRI medication impacts your sex life - Harvard Health
Try out PMC Labs and tell us what you think. Learn More. 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.
When an SSRI medication impacts your sex life
Try out PMC Labs and tell us what you think. Learn More. Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors SSRIs and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care providers should educate patients about SSRI-associated sexual dysfunction in order to promote patient awareness and medication adherence.