[Sexual dysfunctions induced by antidepressants and antipsychotics].

Depressive and schizophrenic patients frequently suffer from sexual dysfunctions. Antidepressants and antipsychotics can aggravate them leading to discontinuation of the treatment. The strategy to decrease these dysfunctions is the following: 1) reducing the dose of medication; 2) changing antidepressant: replace SSRI by moclobemid, trazodone, bupropion, mirtazpine, which do not delay ejaculation; switching to another antipsychotic: quietiapine, olanzapine, aripripazol, which do not increase serum prolactin; 3) taking a drug holiday for two or three days and 4) adding another drug such as sildenafil if impotence, or a dopaminergic agonist (aripripazol, a partial agonist) or cabergoline, in case of hyperprolactinaemia.