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Can monoamine oxidase inhibitors (MAOIs) cause sexual dysfunction?

Phenelzine (brand name Nardil), >tranylcypromine (Parnate), >isocarboxazid (Marplan), and >selegiline (Eldepryl) are drugs called monoamine oxidase inhibitors (MAOIs). These drugs have been associated with sexual dysfunction in some people. Sexual dysfunction is a general term for symptoms such as decreased sex drive, difficulty with erections, loss of sexual sensation, inability to reach orgasm, painful ejaculation, delayed ejaculation, and vaginal dryness. Experts don't know the rate of sexual dysfunction occurring in people taking MAOIs because this effect has not been well recorded. MAOIs may cause less sexual dysfunction than other antidepressants called selective serotonin reuptake inhibitors (SSRIs).

There are several ways to regain normal sexual function while taking antidepressants. Sometimes normal sexual function returns on its own as antidepressant therapy is continued. Another approach is to reduce the antidepressant dose, although this should only be tried under the close supervision of your doctor. Taking a drug holiday, which means skipping your medicine or taking a lower dose on weekends may be helpful, ask your physician before trying this option. Men experiencing sexual dysfunction with MAOI’s may benefit from taking sildenafil >(Viagra). Changing to a different type of antidepressant drug is another option. >Bupropion (Wellbutrin), nefazodone and >mirtazapine (Remeron) are antidepressants with few or no reported sexual side effects.

If you're taking antidepressants and experiencing any symptoms of sexual dysfunction, talk with your doctor so that he or she can recommend appropriate changes in your medications.

Sources:
Segraves, R T. "Antidepressant-Induced Sexual Dysfunction," Journal of Clinical Psychiatry 59 (1998).
Sussman, N. "The Role of Antidepressants in Sexual Dysfunction," Journal of Clinical Psychiatry Monograph 17 (1999).
Gutierrez, M. "Management of and Counseling for Psychotropic Drug-Induced Sexual Dysfunction," Pharmacotherapy 19 (1999).
Micromedex® Healhcare Series. Thomson Micromedex, 2006.
Medline Plus. Medline, 2006.

This answer updated 10/3/2001.
This information updated 12/05/2006.