Antidepressant-induced sexual dysfunction in men

• Antidepressant therapy is associated with sexual dysfunction
• Sexual dysfunction is more common with drugs that increase serotonergic activity
• Sexual dysfunction is less common with drugs with dopaminergic activity
• Sexual dysfunction is less common with drugs with an adrenergic mechanism of action

Most of the available antidepressant medications, including tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and dual noradrenergic/serotonergic reuptake inhibitors have been reported to be associated with sexual dysfunction in both sexes. This manuscript reviews evidence concerning the relative incidence of treatment emergent sexual dysfunction in men being treated with antidepressant drugs. Both double-blind controlled trials and large clinical series report a high incidence of sexual dysfunction, especially ejaculatory delay, with serotonergic drugs. The incidence of sexual dysfunction in men appears to be much lower with drugs whose primary mechanism of action involves adrenergic or dopaminergic systems.