Sertraline sexual function

Fluoxetine, along with sertraline, fluvoxamine, and paroxetine, belongs to the more recently developed group of SSRI. The clinical efficacy of SSRI is considered comparable to that of established antidepressants. Added advantages include absence of cardiotoxicity, fewer autonomic nervous side effects, and relative safety with overdosage. Fluoxetine causes loss of appetite and weight reduction. Its main adverse effects include overarousal, insomnia, tremor, akathisia, anxiety, and disturbances of sexual function. 

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. 

Fluoxetine was the first SSRI to reach general clinical use. Paroxetine and sertraline differ mainly in having shorter half-lives and different potencies as inhibitors of specific P450 isoenzymes. While the SSRIs have not been shown to be more effective overall than prior drugs, they lack many of the toxicities of the tricyclic and heterocyclic antidepressants. Thus, patient acceptance has been high despite adverse effects such as nausea, decreased libido, and even decreased sexual function. 

Croft H, Settle E Jr, Houser T, Batey SR, Donahue RM, Ascher JA. A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther 1999 21(4) 643—58. 

Side effects, such as insomnia, nausea, headache and problems with sexual function, can prove troublesome. One way of minimising such problems is to prescribe the drugs intermittently, restricting treatment to the luteal phase. This has been shown to be an effective strategy in a large-scale placebo-controlled clinical trial of sertraline 50-100 mg taken intermittently (Halbreich et al. 2002). Similar results have been obtained with... 

An isolated case describes spontaneous orgasm with the combined use of bupropion and sertraline. Bupropion had been successfully used to treat SSRI-induced impaired sexual function, but after 6 weeks of combined therapy she experienced a sudden-onset, spontaneous orgasm this occurred again on rechallenge with bupropion. ... 

---