Antidepressant-Induced Sexual Dysfunction: Mechanisms, Genetics, and Prevalence

Bupropion, agomelatine, and nefazodone show sexual dysfunction rates below placebo. Consider these first-line when sexual function is a priority. Ask about oral contraceptive use in women reporting SSRI sexual dysfunction. Combined hormonal and serotonergic effects may compound the problem. Before considering post-SSRI sexual dysfunction (PSSD) after stopping a serotonergic antidepressant, rule out modifiable causes. If a recurrent psychiatric disorder is identified, prioritize psychotherapy or switch to a non-SRI agent.