What is your next step in management for patients who develop sexual side effects on an SSRI (anorgasmia, low libido, etc.) but are responding well to therapy?

Managing side effects from SSRI medications is a key component of treating patients in the outpatient setting who are suffering from depression and/or anxiety. This is doubly true given the fact that primary care is often the most accessible, and often most trusted, source for patients to make their...

Have a conversation with the patient about preference and weigh risks vs benefits.

There are several theoretical possibilities that have been suggested over the past few decades in the literature. Periactin 4 mg 30 minutes prior to sex is noted as a possible intervention. When I've tried this intervention, my patients have reported no benefit from it. Another possibility is to add...