Worst ssri for sex disfunction

Sexual dysfunction is an underdiscussed adverse effect to selective serotonin reuptake inhibitors SSRIs and may increase the risk for discontinuation and nonadherence to antidepressant pharmacotherapy. Given the prevalence of depression, health care providers should educate patients about SSRI-associated sexual dysfunction in order to promote patient awareness and medication adherence. This study evaluated primary literature from to to identify SSRI-related sexual side effects, therapeutic alternatives, and treatment strategies. The results indicate that paroxetine is associated with the greatest rate of sexual dysfunction among the SSRIs. Potential alternatives to SSRI treatment include bupropion, mirtazapine, vilazodone, vortioxetine, and serotonin-norepinephrine reuptake inhibitors. In the event that a subject responds solely to SSRIs but experiences unwanted sexual side effects, bupropion may be added as an adjunctive medication.

The popular medications known as selective serotonin reuptake inhibitors or SSRIs see box can help lift people out from under a dark cloud of depression. But there are some side effects from antidepressants , including those that can affect your sex life. In addition to reducing interest in sex, SSRI medications can make it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren't able to have an orgasm at all. These symptoms tend to become more common with age. If you experience any sexual problems while taking an SSRI medication, talk with your doctor or therapist.

The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women. The focus of this article is to explore the incidence, pathophysiology, and treatment of antidepressant iatrogenic sexual dysfunction.

Resulting sexual dysfunction can impair quality of life and intimate relationships and discourage patients from taking antidepressants Box 1 , 2. Although most reports have focused on SSRIs, all antidepressant classes have been associated with sexual dysfunction, with prevalence likely influenced by differences in neurotransmitter modulation Table 2. A recent study reported similarly high rates with mirtazapine, but its small sample size limits conclusions about side effect prevalence with this drug. Clomipramine appears to have the highest rates of sexual dysfunction—particularly anorgasmia—probably because it inhibits the serotonin transporter more than do other TCAs.