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A 42-year-old man is diagnosed by his primary care physician as having major depressive disorder. The patient tells his physician that he is extremely concerned about his sexual performance, as he is worried that he is getting older and that he is having some marital difficulties with his wife. Which of the following antidepressants would be the best choice for initial treatment?
A. Bupropion
B. Fluoxetine
C. Imipramine
D. Paroxetine
E. Sertraline
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A is the only one improve sexual d..
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The correct answer is A. Bupropion is the antidepressant of the choices listed that has the fewest adverse sexual side effects. Selective serotonin reuptake inhibitors, such as fluoxetine (choice B), paroxetine (choice D), and sertraline (choice E) are all known to be associated with erectile and orgasmic disturbances, such as delayed ejaculation and anorgasmia. Because imipramine (choice C) also has effect on the serotonin levels in the brain, it too has sexual side effects, although to a somewhat lesser degree than the SSRIs
