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Depression Research and Treatment
Volume 2013 (2013), Article ID 256841, 8 pages
http://dx.doi.org/10.1155/2013/256841
Review Article

Reduced Treatment-Emergent Sexual Dysfunction as a Potential Target in the Development of New Antidepressants

1Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO14 3DT, UK
2Department of Psychiatry, University of Cape Town, Cape Town, South Africa
3Department of Pathophysiology and Transplantation, University of Milan and Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
4First Department of Psychiatry, Eginition Hospital, Athens University Medical School, 11528 Athens, Greece

Received 1 October 2012; Revised 18 December 2012; Accepted 3 January 2013

Academic Editor: Charles B. Nemeroff

Copyright © 2013 David S. Baldwin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pleasurable sexual activity is an essential component of many human relationships, providing a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depressive symptoms and depressive illness are associated with impairments in sexual function and satisfaction, both in untreated and treated patients. The findings of randomized placebo-controlled trials demonstrate that most of the currently available antidepressant drugs are associated with the development or worsening of sexual dysfunction, in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts but can endure over long periods and may reduce self-esteem and affect mood and relationships adversely. Sexual dysfunction during antidepressant treatment is typically associated with many possible causes, but the risk and type of dysfunction vary with differing compounds and should be considered when making decisions about the relative merits and drawbacks of differing antidepressants. A range of interventions can be considered when managing patients with sexual dysfunction associated with antidepressants, including the prescription of phosphodiesterase-5 inhibitors, but none of these approaches can be considered “ideal.” As treatment-emergent sexual dysfunction is less frequent with certain drugs, presumably related to differences in their pharmacological properties, and because current management approaches are less than ideal, a reduced burden of treatment-emergent sexual dysfunction represents a tolerability target in the development of novel antidepressants.