Sexual Dysfunction Risks and Management of Duloxetine and Venlafaxine

Adverse‑Effect Listings

• The American Academy of Child and Adolescent Psychiatry classifies sexual dysfunction as an uncommon but potentially serious adverse effect of duloxetine. 1

Management Recommendations

• Clinical guidelines advise that, when sexual dysfunction occurs with an SNRI, clinicians should consider switching to agents with lower rates of sexual side effects—such as bupropion, mirtazapine, or moclobemide—rather than adding another SNRI. 2

• Guidelines warn that co‑administration of duloxetine and venlafaxine markedly raises the risk of serotonin syndrome and compounds sexual side effects; therefore, these agents should never be combined. 3