Sexual dysfunction with psychotropic drugs.

Sexual dysfunction caused by psychotropic medications has become an increasingly important clinical topic. Only recently have we acknowledged the extent to which many psychotropic medications, especially antidepressants and antipsychotics, cause sexual side effects. Prevalence rates of sexual side effects are extraordinarily difficult to estimate due to a variety of factors, such as the effect of the disorder being treated, comorbid disorders and baseline sexual dysfunction. Among the antidepressants, those with strong serotonergic properties have the highest rate of sexual side effects. Among the antipsychotics, those with greater D(2) blockade leading to increased prolactin levels are probably associated with more sexual dysfunction. Treatment approaches have been poorly developed for both antidepressants and antipsychotics. Antidotes for antidepressant-induced sexual dysfunction include bupropion, buspirone and sildenafil.