Clinical management of sexual dysfunctions associated to antidepressant use
Á.L. Montejo González, S. Majadas Fernández, y Grupo Español de Trabajo para el Estudio de las Disfunciones Sexuales Secundarias a Psicofármacos

SUMMARY

The use of antidepressant —mainly SSRIs, venlafaxine and clomipramine— is often associated to sexual dysfunction (SD) appearance. others with a different mechanism of action cause less SD (mirtazpine, bupropion and moclobemide). Unfortunately, the real frequency is often underrated and the use of specific questionnaires is needed (15% with spontaneous communication abandoversus 60% when using questionnaires). The increase of serotonin (5HT2A receptors) leads to delayed orgasm and decreased libido. Erectile dysfunction is related to nitric oxide inhibition as well as adrenergic activation. The management of SD includes waiting for a spontaneous remission, dose reduction, either switching to another antidepressant with a different mechanism of action or use of “antidotes” like sildenafil. Regular investigation of sexual functioning in depressed people will lead to discover sexual dysfunction problems as well as its acceptance by the patient, that often could lead to non compliance

KEY WORDS

Antidepressive agents, depression, sexual dysfunction, questionnaires.