Ejaculatory dysfunction and depression: pharmacological and psychobiological interactions

In recent years, increased attention has been focused on antidepressant-associated sexual dysfunction, largely because of the widespread use of serotonin-specific reuptake inhibitors (SSRIs) and the recognition that such side effects can have a negative impact on treatment compliance. Data suggest that serotonergic antidepressants are associated with delayed ejaculation and anorgasmia, although these sexual problems are also linked to depression and to age. In this review, we discuss central mediators of normal orgasmic functioning and dysfunction, the relationship between depression and sexual dysfunction, possible mechanisms for SSRI-associated sexual dysfunction, and evolving treatment strategies.