A patient presents to your office complaining of a recent inability to have an orgasm when engaging in sexual activities with his wife. He recently started taking fluoxetine to control longstanding depression. Which of the following medications might you consider switching him to in order to best decrease his risk for sexual side effects?
1.mirtazapine
2.imipramine
3.bupropion
4.trazodone
5.citalopram
Correct answer
bupropion
Bupropion is an antidepressant medication that is known to be least likely to cause sexual side effects. It works by blocking the reuptake of dopamine and norepinephrine. Interestingly, it is also used to aid in smoking cessation, as it acts as a nicotinic receptor antagonist.