sexual dysfunction associated with antidepressant

Treatment of sexual dysfunction associated with antidepressant:
Antidepressant that cause sexual dysfunction:
Selective serotonin reuptake inhibitors (SSRI): paroxetine, citalopram, escitalopram, fluoxetine, sertraline, fluvoxamine.
Serotonin-norepinephrine reuptake inhibitors (SNRI): Venlafaxine, Desvenlafaxine, Duloxetine.
SSRI and SNRI have been reported to reduce libido in women and men, to cause anorgasmia in women, and to increase ejaculation latency in men.
Treatment:
Step 1: Decreasing the dose of the SSRI and SNRI will sometimes decrease sexual side effects while maintaining antidepressant efficacy.
Step 2: Use of a second drug:
A number of drugs have also been investigated in combination with SSRIs to alleviate sexual dysfunction.
1- Phosphodiesterase-5 (PDE-5) inhibitors: Sildenafil 50 mg to start, adjustable to 100 mg before sexual activity improve erectile function, arousal, ejaculation and orgasm.
2- ginkgo biloba: In an open trial, 37 male and female patients with selective serotonin reuptake inhibitor (SSRI) associated sexual dysfunction were treated with ginkgo biloba extract. Significant improvement was noted after four weeks in 86 percent of patients.
Dose: Oral: 40-80 mg 3 times/day.