Sexual side effects caused by antidepressants is completely recognized, but this represents a practical problem of managing to physicians. Erectile dysfunction, diminished libido and delayed/attenuated or absent orgasm (dysorgasmia or anorgasmia) is the most common sexual side effects reported because of antidepressant treatment.

Ho-wever, sexual side effects caused by antidepressants is also a very challenge to clinicians, since they have to distinguish bet-ween sexual dysfunction (SD) associated -with depression, treatmentemergent SD and preexisting SD exacerbated by treatment.

Making the difference bet-ween these situations is quite important, since treatment strategies is not the same for the above mentioned SDs. Sexual dysfunction associated -with depression may be treated raising the antidepressant dose, ho-wever, this -would be particularly inappropriate for a treatmentemergent SD, in -which case the appropriate thing is to lo-wer the dose.

For managing appropriately antidepressantinduced sexual dysfunction, experts recommend that clinicians may attempt to alleviate the sexual side effects of a drug though a reduction of the dose and/or a change to an alternative therapy that may be less likely to cause sexual side effects. These strategies is more likely to be used in patients -who is not responding fully to treatment and also risk sacrificing the therapeutic benefit of treatment.

Nonpharmacologic interventions is also recommended by experts. Behavioral and cognitivebehavioral techniques employed by sex therapists is the most common, although there is no studies evaluating their success in patients taking antidepressants.

There exist a number of medications quite useful in the treatment of sexual dysfunction associated -with antidepressants. Under experts' opinion, the most common medications for antidepressantinduced sexual dysfunction fall into three categories:

Dopaminergic agents, such as amantadine and pramipexole.

a2adrenergic receptor antagonists such as yohimbine.

Serotonin 5HT2 or 5HT3 receptor antagonists, including granisetron, nefazodone and cyproheptadine.