Female sexual side effects associated with selective serotonin reuptake inhibitors: a descriptive clinical study of 33 patients

Int J Psychiatry Med. 1995;25(3):239-48. doi: 10.2190/N6C0-DWX2-G4EA-7688.


Objective: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects.

Methods: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects.

Results: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described.

Conclusions: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.

MeSH terms

  • 1-Naphthylamine / adverse effects
  • 1-Naphthylamine / analogs & derivatives
  • 1-Naphthylamine / therapeutic use
  • Adult
  • Antidepressive Agents, Second-Generation / adverse effects*
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Female
  • Fluoxetine / adverse effects
  • Fluoxetine / therapeutic use
  • Humans
  • Libido / drug effects
  • Middle Aged
  • Orgasm / drug effects
  • Paroxetine / adverse effects
  • Paroxetine / therapeutic use
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sertraline
  • Sexual Dysfunctions, Psychological / chemically induced*
  • Sexual Dysfunctions, Psychological / diagnosis
  • Sexual Dysfunctions, Psychological / therapy


  • Antidepressive Agents, Second-Generation
  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Paroxetine
  • 1-Naphthylamine
  • Sertraline