Antidepressants and Female Sexual Dysfunction

Although numerous medications can have an adverse impact on sexual function, few classes of medications have been demonstrated to have more impact on sexual function than antidepressants. Although many of the various classes of antidepressant agents can affect sexual function, the selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, sertraline, or fluoxetine, have been shown to adversely affect libido, arousal, as well as the ability to reach orgasm.27 Under a physician's care, options may include switching agents, dose reduction, or drug holiday. Bupropion (Wellbutrin) may be an effective alternative.28 In addition, studies have suggested that the use of sildenafil with selective SSRI medications may effectively combat the FSD associated with the SSRI. It is also important to recognize that FSD may present with many of the same symptoms as depression, such as poor energy and lack of interest. We have seen numerous patients who were misdiagnosed as having depression, and placed on SSRI drugs (making their FSD worse!), when in fact the primary problem was FSD. Successful management of the underlying cause of the FSD (e.g., hormone replacement therapy for androgen insufficiency syndrome) has allowed many women to stop using antidepressant medications and regain a normal sex life.

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