Task 3 Sexual restrictions or possibilities
Clayton, A., Croft, H., Handiwala, L. (2014). Antidepressants and sexual dysfunction: Mechanisms
and clinical implications. Postgraduate Medicine
Abstract
Both depression and its treatment are associated with sexual dysfunction (SD) in men and women,
including orgasm and arousal problems, hypoactive sexual desire, premature ejaculation, erectile
difficulties, and dyspareunia. SD is frequently cited as a reason for nonadherence niet-therapietrouw
or discontinuation of treatment for depression.
Aim = aid helpen physicians, including primary care physicians, psychiatrists, and
urologists/gynecologist, in the multidisciplinary approach to treating patients with SD and
depression.
Summary = different classes of antidepressants vary in their ability to cause sexual side effects
Results = treatment with selective serotonin reuptake inhibitors SSRIs and serotonin/norepinephrine
reuptake inhibitors (SNRIs) is associated with SD. Use of other ADP, as bupropion, mirtazapine,
nefazodone, and vilazodone have been associated with less SD compared with SSRIs;
Introduction
We present an overview of SD in depression, studies that compare the effects of different ADP on SD,
and strategies for the treatment and prevention of SD during antidepressant therapy.
Sexual dysfunctions in patients with depression
- Antidepressant-induced SD has been reported in up to 70% of patients treated with selective
serotonin reuptake inhibitors (SSRIs) or serotonin/norepinephrine reuptake inhibitors
(SNRIs).
- ADP medications interference with sexual function often results specifically in orgasm or
ejaculatory difficulties
- Neurotransmitters, such as serotonin, dopamine, and norepinephrine are involved in the
physiology of sexual functioning as well as in governing mood heersende stemming; ADP may
increase or decrease the function of these neurotransmitters in various end organs.
o Dopamine = related to motivated behaviors (included sexual behaviors)
o Norepinephrine stimulates sexual arousal and vasocongestion (for bloodflow in penis
and vagina)
o Activation of serotonin systems results in suspension opschorting of vasocongestion,
thus diminishing arousal mechanisms in genital organs
- ADP effects on sexual function differ by gender
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