A patient who has been taking fluoxetine (Prozac) 60 mg daily for the past 6 months tells the nurse at the medication follow-up clinic that he is considering stopping the Prozac
He states his mood is fine, and now that he is living normally, his wife is concerned that he has no sex drive. Which response would be best? a. "Without the medicine the depression will likely return; you and your wife will need to adjust to the sexual side effects.".
b. "If we switch your medication time to the morning, the sexual side effects will be worn off in time for evening sexual activity.".
c. "The problem is not likely due to the medicine. Often the depression itself, even after it improves, continues to dampen sex drive.".
d. "Without an antidepressant, the depression is more likely to reoccur, but there are other medications that do not interfere so much with sex.".
D
The SSRI medications vary in how much they affect sexual function; some have a less negative impact than others and could reduce this problem for the patient and his spouse. Non-SSRI antidepressants might also allow continued treatment of the patient's depression without sexual side effects. Advising the patient to learn to accept the side effects overlooks potential solutions that could reduce the problem and increases the likelihood that the patient will simply become nonadherent to his medication. Changing the medication time will not help the sexual side effects. Although depression often reduces sex drive, in this case the depression has lifted, so the medication is more likely the cause of the sexual problem.
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