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Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility

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Antidepressant-Induced Sexual Dysfunction in Adults: A Targeted Scoping Review and Clinical Update.

Jonathan Zini¹, Gustavo Turecki^1,2

¹McGill University.

Journal of Clinical Psychopharmacology

|June 23, 2026

Summary

Antidepressant-induced sexual dysfunction (AISD) is common, especially with SSRIs/SNRIs. Management involves dose changes, switching medications, or adjunctive therapies, but optimal strategies require more research.

Keywords:

PSSD SNRIs SSRIs anorgasmia antidepressant-induced sexual dysfunction bupropion libido loss psychopharmacology sexual side effects treatment adherence

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Published on: June 6, 2025

Area of Science:

Pharmacology
Neuroscience
Clinical Medicine

Background:

Antidepressant-induced sexual dysfunction (AISD) is a frequent adverse effect impacting patient quality of life and treatment adherence.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly associated with AISD.

Purpose of the Study:

To review the prevalence, risk factors, neurobiological mechanisms, and clinical management of AISD in adults.
To examine emerging evidence on post-SSRI sexual dysfunction (PSSD) and potential mitigation strategies.

Main Methods:

A targeted scoping review with narrative synthesis was performed.
PubMed was searched for English-language studies published between 2000 and 2025, with 65 studies included.

Main Results:

AISD is common, with risk factors including higher antidepressant dose, male sex, older age, pre-existing sexual dysfunction, and depressive severity.
Proposed mechanisms involve serotonergic, dopaminergic, and nitric oxide pathways, with potential epigenetic factors in PSSD.
Bupropion, mirtazapine, and agomelatine show favorable sexual side effect profiles; management includes dose reduction, switching agents, or augmentation with PDE5 inhibitors or bupropion.

Conclusions:

AISD is multifactorial, potentially persistent, and impacts adherence and quality of life.
Individualized assessment and intervention are crucial, though optimal strategies are not fully defined.
Further research into PSSD pathophysiology, prevalence, and treatment is needed.