Antidepressants and psychosexual dysfunction: Part 1 – diagnosis

Sexual dysfunction is frequently experienced during a depressive illness and may be associated with three precipitating or maintaining factors:

• the depressive illness itself

• physical factors

• psychopharmacological treatment.

All three factors can influence each other so that it may often be impossible to work out the contribution of each component, thus it is difficult to identify and quantify the adverse effects of antidepressants alone. Notwithstanding, antidepressant-induced sexual dysfunction remains an important issue in the clinical management of depression.

In routine practice, clinicians may find it difficult to ask patients about sexual function. This may be due to time constraints, a certain uneasiness in approaching the topic or lack of training in this area. Conversely, patients may not volunteer to talk about such problems even if they are significantly affected. Many patients do not realise that such problems may not just be a result of the illness but can also be treatment-related.

The aim of this module is to familiarise clinicians with a systematic approach to the diagnosis of sexual dysfunction associated with antidepressant treatment.

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