Reduced Treatment-Emergent Sexual Dysfunction as a Potential Target in the Development of New Antidepressants
Table 2
Commonly adopted strategies for managing sexual dysfunction associated with antidepressant drugs. Questionnaire survey, US psychiatrists, expertise in managing sexual dysfunction [41]. Percentages indicate the proportion of physicians using that strategy as their preferred intervention.
Dysfunction
Most frequently used treatment strategies first-, second-, and third-line interventions
Impaired libido—men and women
First. Adding a dopaminergic agent (37.9%) Second. Switching to another antidepressant (mostly bupropion) (44.8%) Third. Switching to another antidepressant (mostly bupropion) (31%)
Impaired arousal—women
First. Adding a dopaminergic agent (amantadine, bupropion, stimulants) (37.9%) Second. Adding a dopaminergic agent (amantadine, bupropion, stimulants) (20.4%) Third. Switching to another antidepressant (mostly bupropion) (34.5%)
Impaired arousal—men
First. Adding a dopaminergic agent (mostly stimulants) (31%) Second. Switching to another antidepressant (mostly bupropion) (31%) Third (a). Switching to another antidepressant (mostly bupropion) (37.9%) Third (b). Adding sildenafil, tadalafil, or vardenafil (mostly sildenafil or all three) (37.9%) (a and b used by equal number of experts as a third choice)
Impaired orgasm—women
First. Adding a dopaminergic agent (amantadine, stimulants) (34.5%) Second. Switching to another antidepressant (mostly bupropion) (31%) Third. Switching to another antidepressant (mostly bupropion) (27.5%)
Impaired orgasm —men
First (a). Adding a dopaminergic agent (stimulants) (31%) First (b). Decreasing the dose of antidepressant (31%) Second. Switching to another antidepressant (mostly bupropion) (34.5%) Third. Switching to another antidepressant (mostly bupropion) (31%) (a and b used by equal number of experts as a first choice)