What recommendation should be made to a patient experiencing sexual adverse effects from an SSRI?

When a patient is experiencing sexual adverse effects from a selective serotonin reuptake inhibitor (SSRI), switching to another class of agents is a valuable recommendation. SSRIs can commonly cause sexual dysfunction, including decreased libido, anorgasmia, and erectile dysfunction, due to their impact on serotonin levels, which can inhibit sexual function.

By transitioning to a different class of medications—such as a serotonin-norepinephrine reuptake inhibitor (SNRI) or atypical antidepressants like bupropion, which have a lower incidence of these side effects—a healthcare provider may improve the patient's sexual function while still addressing their underlying depression or anxiety symptoms. This approach is often more effective than adjusting within the same class of medications, as the mechanism of action responsible for the side effects may be similar among SSRIs.

Maintaining the current regimen or switching back to a lower dose may not adequately address the sexual side effects, and an alternative SSRI may still retain the same problems with sexual function. Therefore, recommending a switch to another class of agents not only targets the issue more effectively but also expands treatment options for managing the patient's mental health condition.