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Abstract
There are many management strategies and antidotes available for sexual dysfunction associated with antidepressants available. However, only a few of these strategies and antidotes were tested in rigorous trials and most of them probably will not be rigorously tested. Surveying the prescribing practices of experts in this area provides another opportunity to evaluate these strategies and antidotes. The authors surveyed 29 (of 50) “expert” psychiatrists in the area of sexual dysfunction associated with antidepressants. Switching to another antidepressant, decreasing the dose of an antidepressant, and adding oral agents such as bupropion, phosphodiesterase-5 inhibitors, and some dopaminergic agents (dextroamphetamine, methylphenidate) and a testosterone patch in some dysfunctions (libido, orgasm) are management strategies most frequently used by the experts. The experts also consider these strategies as the most effective ones. These findings are compared with other studies and discussed with regard to the evidence from clinical trials.
Notes
∗14–120 days
∗∗mostly bupropion
∗∗∗various (ropinirol); phosphodiesterase-5 inhibitors; modafinil.
∗ 14–180 days
∗∗mostly bupropion
∗∗∗local preparation
+amantadine, burpropion, stimulants
++buspirone, stimulants, testosterone
∗ 14–90 days
∗∗mostly bupropion
∗∗∗with short acting SSRI
+topical
++mostly stimulants; & mostly sildenafil or all three.
∗ 14–120 days
∗∗mostly bupropion, once mirtazapine, nefazodone
∗∗∗postmenopausal
+amantadine, stimulants
++buspirone, modafinil; & mostly sildenafil.
∗14–20 days
∗∗mostly bupropion, once mirtazapine, nefazodone
∗∗∗stimulants
+buspirone, modafinil, yohimbine
++mostly sildenafil, vardenafil.