Management strategies for antidepressant-related sexual dysfunction: a clinical approach

Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect t...

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Detalhes bibliográficos
Autores: Montejo González, Ángel Luis, Prieto, Nieves, de Alarcón, Rubén, Casado-Espada, Nerea, de la Iglesia, Javier, Montejo, Laura
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/161800
Acesso em linha:http://hdl.handle.net/10366/161800
Access Level:acceso abierto
Palavra-chave:Antidepressant
Antidepresivos
Disfunción sexual
Sexual dysfunction
Erectile dysfunction
Disfunción eréctil
Anorgasmia
Orgasm retardation
TESD
Management strategies
Estrategias de manejo
Erectile Dysfunction
Antidepressive Agents
antidepresivos
disfunción eréctil
id ES_ccb2ea20ff0700cf27508d1c0296cc41
oai_identifier_str oai:gredos.usal.es:10366/161800
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network_name_str España
repository_id_str
spelling Management strategies for antidepressant-related sexual dysfunction: a clinical approachMontejo González, Ángel LuisPrieto, Nievesde Alarcón, RubénCasado-Espada, Nereade la Iglesia, JavierMontejo, LauraAntidepressantAntidepresivosDisfunción sexualSexual dysfunctionErectile dysfunctionDisfunción eréctilAnorgasmiaOrgasm retardationTESDManagement strategiesEstrategias de manejoErectile DysfunctionAntidepressive Agentsantidepresivosdisfunción eréctilMajor depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, “weekend holiday”, or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.https://www.mdpi.com/2077-0383/8/10/1640202520252019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/161800reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1618002026-06-07T06:28:51Z
dc.title.none.fl_str_mv Management strategies for antidepressant-related sexual dysfunction: a clinical approach
title Management strategies for antidepressant-related sexual dysfunction: a clinical approach
spellingShingle Management strategies for antidepressant-related sexual dysfunction: a clinical approach
Montejo González, Ángel Luis
Antidepressant
Antidepresivos
Disfunción sexual
Sexual dysfunction
Erectile dysfunction
Disfunción eréctil
Anorgasmia
Orgasm retardation
TESD
Management strategies
Estrategias de manejo
Erectile Dysfunction
Antidepressive Agents
antidepresivos
disfunción eréctil
title_short Management strategies for antidepressant-related sexual dysfunction: a clinical approach
title_full Management strategies for antidepressant-related sexual dysfunction: a clinical approach
title_fullStr Management strategies for antidepressant-related sexual dysfunction: a clinical approach
title_full_unstemmed Management strategies for antidepressant-related sexual dysfunction: a clinical approach
title_sort Management strategies for antidepressant-related sexual dysfunction: a clinical approach
dc.creator.none.fl_str_mv Montejo González, Ángel Luis
Prieto, Nieves
de Alarcón, Rubén
Casado-Espada, Nerea
de la Iglesia, Javier
Montejo, Laura
author Montejo González, Ángel Luis
author_facet Montejo González, Ángel Luis
Prieto, Nieves
de Alarcón, Rubén
Casado-Espada, Nerea
de la Iglesia, Javier
Montejo, Laura
author_role author
author2 Prieto, Nieves
de Alarcón, Rubén
Casado-Espada, Nerea
de la Iglesia, Javier
Montejo, Laura
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Antidepressant
Antidepresivos
Disfunción sexual
Sexual dysfunction
Erectile dysfunction
Disfunción eréctil
Anorgasmia
Orgasm retardation
TESD
Management strategies
Estrategias de manejo
Erectile Dysfunction
Antidepressive Agents
antidepresivos
disfunción eréctil
topic Antidepressant
Antidepresivos
Disfunción sexual
Sexual dysfunction
Erectile dysfunction
Disfunción eréctil
Anorgasmia
Orgasm retardation
TESD
Management strategies
Estrategias de manejo
Erectile Dysfunction
Antidepressive Agents
antidepresivos
disfunción eréctil
description Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, “weekend holiday”, or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.
publishDate 2019
dc.date.none.fl_str_mv 2019
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10366/161800
url http://hdl.handle.net/10366/161800
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv https://www.mdpi.com/2077-0383/8/10/1640
publisher.none.fl_str_mv https://www.mdpi.com/2077-0383/8/10/1640
dc.source.none.fl_str_mv reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname:Universidad de Salamanca (USAL)
instname_str Universidad de Salamanca (USAL)
reponame_str GREDOS. Repositorio Institucional de la Universidad de Salamanca
collection GREDOS. Repositorio Institucional de la Universidad de Salamanca
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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