Sexual Dysfunction With Antidepressants – Pathophysiology | Assessment | Management

Posted on:August 17, 2021
Last Updated: September 13, 2022
Time to read: 10–12 minutes

Sexual dysfunction is a persistent change occurring in any of the stages of the sexual response cycle that causes distress to the patient.

There are 4 stages of the sexual response cycle:

1. Pleasure

2. Desire

3. Arousal

4. Orgasm

Sexual dysfunction (SD) is a known side-effect with certain antidepressants and is also associated with depression. Differentiating the two may be challenging in clinical practice.

Depression is associated with a 50-70% increased risk of sexual dysfunction, while sexual dysfunction itself increases the risk of depression by 130-200%. [Chokka & Hankey, 2018]

The severity of depression is correlated with the severity of sexual dysfunction. In men, the presence of SD is determined by the severity and, to a certain extent, type of their depression, with atypical depression having a lower rate of SD compared to patients with major depressive disorder (MDD). [Fabre et al., 2013]

In the general population, the prevalence of SD is approximately 43% in women and 31% in males. This prevalence increases to approximately 60-80% in anxiety, mood, or psychotic disorders. [Taylor et al., 2021]