Antidepressants: The spectrum beyond depression

Sertraline, on the other hand, might exert antifungal activity. Three patients with recurrent vulvovaginal candidiasis had no episodes while being treated with sertraline for premenstrual dysphoric disorder but relapsed when the drug was discontinued.²⁶ Although sertraline demonstrated antifungal activity in vitro against several Candida species, this SSRI seems unlikely to gain prominence as an antifungal agent.

Sexual function

Premature ejaculation. SSRIs are well-known causes of delayed or absent orgasm, but a perceived liability can become an asset in treating premature ejaculation. By measuring intravaginal ejaculation latency time under double-blind, placebo-controlled conditions, Waldinger et al²⁷ showed pronounced delay in ejaculation with sertraline, fluoxetine, and paroxetine in men with long-standing rapid ejaculation. Dapoxetine—a short-acting non-antidepressant SSRI—is being studied as a treatment for this condition (Box 3).²⁸

Spermicidal effect. SSRIs—including fluoxetine— have demonstrated in vitro spermicidal and antitrichomonas activity²⁹ but are unlikely to be developed as microbicidal contraceptives.

Related Resources

• Gorman JM, Kent JM. SSRIs and SMRIs: broad spectrum of efficacy beyond major depression. J Clin Psychiatry 1999;60(suppl 4):33-8.
  
• About.com: Mental Health. Antidepressants for more than depression. https://mentalhealth.about.com/cs/psychopharmacology/a/antimore.htm.
  

• Amitriptyline • Elavil, Endep
  
• Bupropion • Wellbutrin, Zyban
  
• Citalopram • Celexa
  
• Clomipramine • Anafranil
  
• Desipramine • Norpramin, Pertofrane
  
• Doxepin • Adapin, Sinequan
  
• Duloxetine • Cymbalta
  
• Escitalopram • Lexapro
  
• Fludrocortisone • Florinef
  
• Fluoxetine • Prozac
  
• Fluvoxamine • Luvox
  
• Imipramine • Tofranil
  
• Midodrine • ProAmitine
  
• Nortriptyline • Pamelor, Aventyl
  
• Paroxetine • Paxil
  
• Phenelzine • Nardil
  
• Sertraline • Zoloft
  
• Trimipramine • Surmontil
  
• Venlafaxine • Effexor
  

Dr. Jefferson receives research support from Bristol-Myers Squibb, Forest Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceutica, Eli Lilly and Company, Novartis, Pfizer, Roche, Solvay, UCB Pharma, and Wyeth. He is a consultant to GlaxoSmithKline, Schwarz Pharma, Shire, and Organon and a speaker for Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Forest Pharmaceuticals, GlaxoSmithKline, Eli Lilly and Company, Pfizer, Schwarz Pharma, Shire, and Wyeth. He holds stock in Bristol-Myers Squibb, GlaxoSmithKline, and SciClone.