Care of the sexually active depressed patient

Robert M A Hirschfeld

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

There are several possible causes of sexual dysfunction in depressed patients. A core symptom of depression is anhedonia, including loss of libido. Therefore, determining a cause of sexual dysfunction in a depressed patient can be very difficult, and the differential diagnosis must include a primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorders, and sexual dysfunction associated with treatments for psychiatric disorders. Of particular clinical interest is sexual dysfunction associated with different classes of antidepressant drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, or venlafaxine. Sexual dysfunction's pharmacologic basis is thought to be stimulation of 5-HT2 receptors. Antidepressant-induced sexual dysfunction, most frequently presenting as a reduction in libido or delayed orgasm, may not pose a large burden for patients in acute treatment. However, in long- term treatment, patients are generally well, and anything that interferes with sexual functioning will be a greater problem and will contribute strongly to noncompliance. Different strategies are advised when dealing with sexual dysfunction in depressed patients treated with antidepressant drugs: waiting for a spontaneous resolution of a problem, reduction in antidepressant drug dosages, drug holidays, adjunctive pharmacotherapy, or switching antidepressants. Perhaps the best way is to avoid sexual dysfunction by starting treatment with an antidepressant with proven acute and long-term efficacy that is devoid of sexual side effects, for example, mirtazapine, bupropion, or nefazodone.

Original languageEnglish (US)
Pages (from-to)32-35
Number of pages4
JournalJournal of Clinical Psychiatry
Volume60
Issue numberSUPPL. 17
StatePublished - 1999

Fingerprint

Antidepressive Agents
Libido
Psychiatry
Anhedonia
Orgasm
Bupropion
Holidays
Tricyclic Antidepressive Agents
Serotonin Uptake Inhibitors
Therapeutics
Differential Diagnosis
Depression
Drug Therapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Hirschfeld, R. M. A. (1999). Care of the sexually active depressed patient. Journal of Clinical Psychiatry, 60(SUPPL. 17), 32-35.

Care of the sexually active depressed patient. / Hirschfeld, Robert M A.

In: Journal of Clinical Psychiatry, Vol. 60, No. SUPPL. 17, 1999, p. 32-35.

Research output: Contribution to journalArticle

Hirschfeld, RMA 1999, 'Care of the sexually active depressed patient', Journal of Clinical Psychiatry, vol. 60, no. SUPPL. 17, pp. 32-35.
Hirschfeld, Robert M A. / Care of the sexually active depressed patient. In: Journal of Clinical Psychiatry. 1999 ; Vol. 60, No. SUPPL. 17. pp. 32-35.
@article{39bf09b0b34d42aca4227536e33e5274,
title = "Care of the sexually active depressed patient",
abstract = "There are several possible causes of sexual dysfunction in depressed patients. A core symptom of depression is anhedonia, including loss of libido. Therefore, determining a cause of sexual dysfunction in a depressed patient can be very difficult, and the differential diagnosis must include a primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorders, and sexual dysfunction associated with treatments for psychiatric disorders. Of particular clinical interest is sexual dysfunction associated with different classes of antidepressant drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, or venlafaxine. Sexual dysfunction's pharmacologic basis is thought to be stimulation of 5-HT2 receptors. Antidepressant-induced sexual dysfunction, most frequently presenting as a reduction in libido or delayed orgasm, may not pose a large burden for patients in acute treatment. However, in long- term treatment, patients are generally well, and anything that interferes with sexual functioning will be a greater problem and will contribute strongly to noncompliance. Different strategies are advised when dealing with sexual dysfunction in depressed patients treated with antidepressant drugs: waiting for a spontaneous resolution of a problem, reduction in antidepressant drug dosages, drug holidays, adjunctive pharmacotherapy, or switching antidepressants. Perhaps the best way is to avoid sexual dysfunction by starting treatment with an antidepressant with proven acute and long-term efficacy that is devoid of sexual side effects, for example, mirtazapine, bupropion, or nefazodone.",
author = "Hirschfeld, {Robert M A}",
year = "1999",
language = "English (US)",
volume = "60",
pages = "32--35",
journal = "Journal of Clinical Psychiatry",
issn = "0160-6689",
publisher = "Physicians Postgraduate Press Inc.",
number = "SUPPL. 17",

}

TY - JOUR

T1 - Care of the sexually active depressed patient

AU - Hirschfeld, Robert M A

PY - 1999

Y1 - 1999

N2 - There are several possible causes of sexual dysfunction in depressed patients. A core symptom of depression is anhedonia, including loss of libido. Therefore, determining a cause of sexual dysfunction in a depressed patient can be very difficult, and the differential diagnosis must include a primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorders, and sexual dysfunction associated with treatments for psychiatric disorders. Of particular clinical interest is sexual dysfunction associated with different classes of antidepressant drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, or venlafaxine. Sexual dysfunction's pharmacologic basis is thought to be stimulation of 5-HT2 receptors. Antidepressant-induced sexual dysfunction, most frequently presenting as a reduction in libido or delayed orgasm, may not pose a large burden for patients in acute treatment. However, in long- term treatment, patients are generally well, and anything that interferes with sexual functioning will be a greater problem and will contribute strongly to noncompliance. Different strategies are advised when dealing with sexual dysfunction in depressed patients treated with antidepressant drugs: waiting for a spontaneous resolution of a problem, reduction in antidepressant drug dosages, drug holidays, adjunctive pharmacotherapy, or switching antidepressants. Perhaps the best way is to avoid sexual dysfunction by starting treatment with an antidepressant with proven acute and long-term efficacy that is devoid of sexual side effects, for example, mirtazapine, bupropion, or nefazodone.

AB - There are several possible causes of sexual dysfunction in depressed patients. A core symptom of depression is anhedonia, including loss of libido. Therefore, determining a cause of sexual dysfunction in a depressed patient can be very difficult, and the differential diagnosis must include a primary sexual dysfunction, sexual dysfunction associated with general medical and psychiatric disorders, and sexual dysfunction associated with treatments for psychiatric disorders. Of particular clinical interest is sexual dysfunction associated with different classes of antidepressant drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, or venlafaxine. Sexual dysfunction's pharmacologic basis is thought to be stimulation of 5-HT2 receptors. Antidepressant-induced sexual dysfunction, most frequently presenting as a reduction in libido or delayed orgasm, may not pose a large burden for patients in acute treatment. However, in long- term treatment, patients are generally well, and anything that interferes with sexual functioning will be a greater problem and will contribute strongly to noncompliance. Different strategies are advised when dealing with sexual dysfunction in depressed patients treated with antidepressant drugs: waiting for a spontaneous resolution of a problem, reduction in antidepressant drug dosages, drug holidays, adjunctive pharmacotherapy, or switching antidepressants. Perhaps the best way is to avoid sexual dysfunction by starting treatment with an antidepressant with proven acute and long-term efficacy that is devoid of sexual side effects, for example, mirtazapine, bupropion, or nefazodone.

UR - http://www.scopus.com/inward/record.url?scp=0032840717&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032840717&partnerID=8YFLogxK

M3 - Article

VL - 60

SP - 32

EP - 35

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

SN - 0160-6689

IS - SUPPL. 17

ER -