Sexual function antidepressant drugs

Stahl s Essential Psychopharmacology has established itself as the preeminent source of education and information in its field. This much expanded second edition enlists advances in neurobiology and recent clinical developments to explain with renewed clarity the concepts underlying drug treatment of psychiatric disorders. New neurotransmitter systems, new theories of schizophrenia, clinical advances in antipsychotic and antidepressant therapy, new coverage of attention deficit disorder, sleep disorders, and drug abuse, and a new chapter on sex-specific and sexual function-related psychopharmacology—these are all features of this edition. 

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. 

Antidepressant drugs can rarely cause priapism. The agent most often implicated has been trazodone, perhaps because of its ai-adrenoceptor antagonist properties. In general venlafaxine has an inhibitory effect on sexual function, but perhaps, like SSRIs, it can rarely cause priapism (23). 

Balon, R., Harvey, K. V. (1995). Clinical implications of antidepressant drug effects on sexual function. Annals of Clinical Psychiatry, 7(4), 189-201. 

The new wave of safer antidepressants introduced in the 1990s, led by fluoxetine (Prozac),is dominated by drugs that are serotonin-selective reuptake inhibitors (SSRIs). The SSRIs exhibit some adverse side effects, notably in impaired sexual function in both men and women, but because they are relatively safe physicians have been less inhibited about using them. This has extended the clin-... 

Sedation is uncommon and instead many patients will find that these drugs may impair sleep, which is why the dose is best taken in the morning. There is also little effect on psychomotor function. Occasional patients have a small reduction in heart rate but otherwise effects on the cardiovascular system are rare. Epileptic convulsions can occur but are rare and much less common than with tricyclic antidepressants. There is some evidence for potentiation of electroconvulsive therapy (ECT)-induced seizures. Sexual dysfunction is reported, principally delayed ejaculation and anorgasmia. 

Anabolic steroids, antidepressants and drugs of abuse affect libido, potency, and ejaculatory function. Anabolic steroids are derivatives of testosterone, and have strong genitotropic effects. There is published evidence indicating that anabolic steroids increases sexual desire however, the frequency of erectile dysfunction is also increased. Treatment with the antidepressant fluoxetine has been associated with sexual side effects including delayed or nonexistent ejaculation and hyposexuality. Mice treated in utero with the anideukemic agent 5-aza-2/-deoxycytidine exhibit abnormal reproductive behavior and low reproductive capacity. 

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