Reduced Treatment-Emergent Sexual Dysfunction as a Potential Target in the Development of New Antidepressants

Table 2

Commonly adopted strategies for managing sexual dysfunction associated with antidepressant drugs. Questionnaire survey, US psychiatrists, expertise in managing sexual dysfunction [41]. Percentages indicate the proportion of physicians using that strategy as their preferred intervention.

Dysfunction	Most frequently used treatment strategies first-, second-, and third-line interventions
Impaired libido—men and women	First. Adding a dopaminergic agent (37.9%); Second. Switching to another antidepressant (mostly bupropion) (44.8%); Third. Switching to another antidepressant (mostly bupropion) (31%)
Impaired arousal—women	First. Adding a dopaminergic agent (amantadine, bupropion, stimulants) (37.9%); Second. Adding a dopaminergic agent (amantadine, bupropion, stimulants) (20.4%); Third. Switching to another antidepressant (mostly bupropion) (34.5%)
Impaired arousal—men	First. Adding a dopaminergic agent (mostly stimulants) (31%); Second. Switching to another antidepressant (mostly bupropion) (31%); Third (a). Switching to another antidepressant (mostly bupropion) (37.9%); Third (b). Adding sildenafil, tadalafil, or vardenafil (mostly sildenafil or all three) (37.9%); (a and b used by equal number of experts as a third choice)
Impaired orgasm—women	First. Adding a dopaminergic agent (amantadine, stimulants) (34.5%); Second. Switching to another antidepressant (mostly bupropion) (31%); Third. Switching to another antidepressant (mostly bupropion) (27.5%)
Impaired orgasm —men	First (a). Adding a dopaminergic agent (stimulants) (31%); First (b). Decreasing the dose of antidepressant (31%); Second. Switching to another antidepressant (mostly bupropion) (34.5%); Third. Switching to another antidepressant (mostly bupropion) (31%); (a and b used by equal number of experts as a first choice)