Nefazodone sexual function

In cases where the antidepressant response has not been resounding, we prefer switching antidepressants to avoid sexual side effects. The options include bupropion, nefazodone, and mirtazapine, which all effectively treat depression but produce minimal effects on sexual function. Sometimes, if a patient has responded well to one antidepressant but experiences a side effect such as sexual dysfunction, switching within the same class can be a useful approach. 

Feiger, A., Kiev, A., Shrivastava, R.K., Wisselink, P.G., and Wilcox, C.S. (1996) Nefazodone versus sertraline in outpatients with major depression focus on efficacy, tolerability, and effects on sexual function and satisfaction. / Clm Psychiatry 57 53-62. 

Bakish D, Hooper CL, Filteau MJ, et al A double-blind placebo-controlled trial comparing fluvoxamine and imipramine in the treatment of panic disorder with or without agoraphobia. Psychopharmacol Bull 32 135-141, 1996 Bakish D, Hooper CL, Thorton MD, et al Fast onset an open study of the treatment of major depressive disorder with nefazodone and pindolol combination therapy. Int Clin Psychopharmacol 12 91-97, 1997 Baldwin DS Depression and sexual function. J Psychopharmacol 10 (suppl l) 30-34, 1996... 

Zajecka J, Dunner DL, Hirschfeld R, et al. Sexual function and satisfaction in the treatment of chronic depression with nefazodone, psychotherapy and their combination. 40th Annual Meeting NCDEU, Boca Raton, Florida, 2000. 

There are many other ways in which SSRIs can interfere with sexual function, for example by causing loss of sexual interest and erectile difficulties. In an open, prospective study of 1000 Spanish patients taking a variety of antidepressants, there was an overall incidence of sexual dysfunction of 59% (15). The highest rates, 60-70%, were found with SSRIs (including fluvoxamine) and venlafax-ine. The lowest rates were found with mirtazepine (24%), nefazodone (8%), and moclobemide (4%). Spontaneous resolution of this adverse effect was uncommon - 80% of subjects had no improvement in sexual function over 6 months of treatment. 

Nefazodone lacks antimuscarinic effects but may cause postural hypotension and abdominal discomfort. It appears to improve sleep quality and seems not to interfere with sexual function. 

Nefazodone hydrochloride (brand name Serzone) An antidepressant that functions as an SSNRI used in the treatment of severe depression. Some side effects include blurred or abnormal vision, dry mouth, nausea, and weakness. This medication may be considered the drag of choice for those with depression who also have a lack of sexual interest and difficulty with performance. 

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