Antidepressants with Lesser Sexual Dysfunction Side Effects

Comparative Sexual Side Effect Profiles of Antidepressants

• Bupropion is the antidepressant with the lowest risk of sexual dysfunction and should be considered as a first-line option for patients concerned about sexual side effects 1, 2, 3
• Paroxetine specifically shows higher rates of sexual dysfunction than fluoxetine, fluvoxamine, nefazodone, or sertraline 1, 2, 3

Clinical Decision Making

• The American College of Physicians recommends selecting antidepressants based on adverse effect profiles, cost, and patient preferences 1, 4

Important Considerations and Caveats

• Weak evidence suggests bupropion may be associated with an increased risk for seizures 2, 3
• Efficacy for treating depression is generally similar across second-generation antidepressants 1, 5
• Sexual dysfunction is often underreported in clinical trials 2, 3
• Other common side effects across antidepressants include constipation, diarrhea, dizziness, headache, insomnia, nausea, and somnolence 1, 5