Sexual side effects caused by drugs that reduce depression are completely recognized, but this represents a practical problem of managing to physicians. Erectile dysfunction, diminished libido and delayed/attenuated or absent orgasm (dysorgasmia or anorgasmia) are the foremost common sexual side effects reported as a result of antidepressant treatment.
However, sexual side effects caused by antidepressants are also a very challenge to clinicians, since they have to distinguish between sexual dysfunction (SD) associated with depression, treatment-emergent SD and pre-existing SD exacerbated by treatment.
Making the difference between these situations is sort of important, since treatment strategies aren’t an equivalent for the above mentioned SDs. Sexual harmful, angry behaviors related to depression could also be treated raising the antidepressant dose,, however, this is able to be particularly inappropriate for a treatment-emergent SD, during which case the appropriate thing is to bring down the dose.
For managing appropriately antidepressant-induced sexual dysfunction, experts recommend that clinicians may decide to alleviate the sexual side effects of a drug though a reduction of the dose and/or a change to an alternate therapy which will be less likely to cause sexual side effects. These strategies are more likely to be utilized in patients who aren’t responding fully to treatment and also risk sacrificing the therapeutic advantage of treatment.
Nonpharmacologic interventions are also recommended by experts. Behavioral and cognitive-behavioral techniques employed by sex therapists are the most common, although there are not any studies evaluating their success in patients taking antidepressants.
There exist a number of medicines quite useful in the treatment of sexual dysfunction related to antidepressants. Under experts’ opinion, the most common medications for antidepressant-induced sexual dysfunction fall into three categories:
Dopaminergic agents, such as amantadine and pramipexole.
a2-adrenergic receptor antagonists such as yohimbine.