Management strategies for antidepressant-related sexual dysfunction

Frank Lach; Hugo Bottemanne; Coraline Hingray; Didier Papeta; Amélie Rousseau; Hervé Javelot

doi:10.1016/j.encep.2023.11.025

Management strategies for antidepressant-related sexual dysfunction

Encephale. 2024 Feb 3:S0013-7006(24)00015-0. doi: 10.1016/j.encep.2023.11.025. Online ahead of print.

Authors

Frank Lach¹, Hugo Bottemanne², Coraline Hingray³, Didier Papeta⁴, Amélie Rousseau⁵, Hervé Javelot⁶

Affiliations

¹ Centre de Ressources et d'Expertise en Psychopharmacologie du Grand'Est (CREPP GE), Établissement Public de Santé Alsace Nord (EPSAN), Brumath, France. Electronic address: frank.lach@ch-epsan.fr.
² Paris Brain Institute, Institut du Cerveau, Sorbonne University, CNRS, Inserm, Assistance publique-Hôpitaux de Paris (AP-HP), Paris, France.
³ Pôle Universitaire du Grand Nancy, CPN, Unité Neuropsychiatrique, CHRU de Nancy, Nancy, France.
⁴ Cabinet Libéral, Brest, France.
⁵ Centre de Ressources et d'Expertise en Psychopharmacologie du Grand'Est (CREPP GE), Établissement Public de Santé Alsace Nord (EPSAN), Brumath, France.
⁶ Centre de Ressources et d'Expertise en Psychopharmacologie du Grand'Est (CREPP GE), Établissement Public de Santé Alsace Nord (EPSAN), Brumath, France; Laboratoire de Pharmacologie et Toxicologie Neurocardiovasculaire, UR7296, Faculté de Médecine, Strasbourg & Section Neuropsychopharmacologie, Association Française de Psychiatrie Biologique et de Neuropsychopharmacologie (AFPBN), Saint-Germain-en-Laye, France.

PMID: 38311476
DOI: 10.1016/j.encep.2023.11.025

Abstract

Antidepressant-related sexual dysfunction is one of the most frequently met adverse effects for individuals suffering from major depressive disorder. When primary prevention by non-pharmacological measures fails, empirical coping strategies might be proposed. In this article, we present a brief overview of pharmacological strategies for antidepressant-related sexual dysfunction, considering antidepressants and conceivable corrective medications. We suggest dividing these strategies into three groups: (1) tapering (dose reduction, therapeutic window or short-term treatment interruption); (2) maintenance (focusing on spontaneous remission); (3) optimizing treatment (substitution for another antidepressant or addition of treatments to correct sexual side effects). Whichever strategy is selected, we encourage the clinician to propose the most adequate therapeutic option for the patient, while considering the efficacy and overall tolerance of the current antidepressant strategy, the affected phase of sexuality and patient preferences and gender. This summary is limited to antidepressant treatments and correctors marketed in France and aimed at a clinician reading to help manage patients suffering from antidepressant-induced sexual dysfunction.

Keywords: Antidepressants; Antidépresseurs; Corrective strategies; Depression; Effets indésirables; Sexual disorders; Side effects; Stratégies correctrices; Troubles sexuels.