Clinical depression is the most common psychiatric disorder, and recent evidence suggests that it is the disorder seen most often by primary care physicians. It also is often present with other illnesses and disorders, like sexual dysfunction.

A number of recent studies have shown that the rate of sexual dysfunction of one type or another among untreated individuals suffering from depression approaches 50 percent. The most frequently seen problem in both men and women is the reduction in sexual desire, followed by problems with arousal (erection in men) and difficulties with orgasm or ejaculation.

Some clinicians see sexual dysfunction in this context as just a part of the depression, something that will go away when the mood disorder is effectively treated. However, evidence suggests that this is not always the case. This is particularly true with modern approaches to treating depression, which typically involve long-term use of antidepressant medication. In fact, there is strong evidence that the SSRI antidepressants, like Prozac?, Zoloft?, Paxil?, frequently cause sexual difficulties, with some studies showing rates of more than 60 percent.

Physicians and patients are reluctant to stop the very drugs that help manage depression, so the sexual problems have to be treated as well. This can be done effectively. The dose of the antidepressant drug can be adjusted, a drug can be prescribed to address the sexual dysfunction, all medications can be stopped for a period (under a doctor?s care) to see how the patient responds, or a new antidepressant with fewer sexual side effects can be tried. Sometimes effective treatment of depression with sexual dysfunction involves trial and error, but in most cases, the problem can be solved.

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SOURCE: The Journal of Urology