Understanding Antidepressant-Induced Sexual Dysfunction

Sexual Functioning and Dysfunction

Sexual functioning is a complex process involving biological, psychological, emotional, and social factors. Sexual dysfunction is characterized by a disturbance in the sexual response cycle desire, arousal, excitement, orgasm, and resolution or by pain with sexual intercourse. It is commonly associated with many diseases, such as diabetes and high blood pressure, and drugs, particularly blood pressure medications, anti-ulcer drugs, alcohol, sedative/hypnotics, mood stabilizers, antipsychotics, and antidepressants. Depression itself can cause decreased libido, diminished erectile function, and decreased sexual activity. All antidepressants can have sexual side effects.

Antidepressant-Induced Sexual Dysfunction

Reports show that between 30 and 70 percent of people who take antidepressants experience sexual dysfunction. The mechanism behind antidepressant-induced sexual dysfunction is not completely understood, but is thought to be related to increased levels of the brain chemical serotonin and decreased levels of another neurotransmitter, dopamine level decreases. The severity of sexual side effects depends on the individual and the type of antidepressant. Wellbutrin, Remeron, and Desyrel are associated with the lowest risk for sexual dysfunction, whereas SSRIs and SNRIs are generally associated with higher rates. In fact, approximately one-third of patients taking SSRIs develop sexual dysfunction. The rates of sexual dysfunction associated with TCAs and MAOIs are more difficult to estimate. Studies indicate moderate rates of sexual dysfunction with these older antidepressants. Antidepressant-associated sexual dysfunction generally occurs early in treatment and then may improve or persist.

Low Libido

Low libido is the most common type of sexual dysfunction and is present in up to three-quarters of depressed patients.