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Adult SSRI-Induced Sexual Dysfunction
Adult SSRI-Induced Sexual Dysfunction
Diagnosis
Medication
Recommendation
Sexual dysfunction
Female- Low Libido
Female- Orgasmic Disorder
Male- Erectile Dysfunction
X
Yes
Inadequate
Response
Inadequate
Response
Mild/Moderate
Severe
Adequate
response
No
SSRI Induced
Sexual Dysfunction
SSRI effective?
Watchful waiting x 2-3 mo
Psychotherapy
Behavioral Modifications
(Tailor intervention as
Appropriate)
Consider decreasing SSRI
dose as appropriate
Assess level of severity of
sexual dysfunction
Female
low libido
Add Bupropion XL
titrate as appropriate
to 300 mg/day
Reassess severity
Female orgasmic
disorder
Add PDE5-i
(Sildenafil)
Switch to other non SSRI/SNRI
medication per
corresponding decision support
(i.e Bupropion, Mirtazapine,)
Some SSRI's (Escitalopram/Citalopram),
Serotonin Modulators (Vortioxetine, Vilazodone)
or SNRI's may have lower incidence of sexual
side effects
Male with
erectile dysfunction
Add PDE5-i
(Sildenafil
Tadalafil)
Maintain SSRI
at new dose
Psychotherapy:
Sexual therapy
Couples therapy
Mindfulness
Behavior Modification
Lifestyle changes
Body image
Sleep hygiene
Stress Reduction
Pelvic therapy
Relationship building
Sexual novelty