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Analysis of institutional authors

Montejo, LauraCorresponding Author

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Management Strategies for Antidepressant-Related Sexual Dysfunction: A Clinical Approach

Publicated to:Journal Of Clinical Medicine. 8 (10): E1640- - 2019-10-01 8(10), DOI: 10.3390/jcm8101640

Authors: Montejo, Angel L; Prieto, Nieves; de Alarcon, Ruben; Casado-Espada, Nerea; de la Iglesia, Javier; Montejo, Laura

Affiliations

Univ Barcelona, Inst Neurosci, Barcelona Bipolar & Depress Disorders Program, IDIBAPS,CIBERSAM, Catalonia 08401, Spain - Author
Univ Salamanca, Clin Hosp, Psychiat Serv, Inst Biomed Res Salamanca IBSAL, Salamanca 37007, Spain - Author
Univ Salamanca, EUEF, Donantes Sangre St SN, Salamanca 37007, Spain - Author

Abstract

Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients' tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, weekend holiday, or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.

Keywords

anorgasmiaantidepressanterectile dysfunctionmanagement strategiesorgasm retardationsexual dysfunctiontesd20 mg2nd-generation antidepressants5 inhibitorAgomelatineAgomelatine 25Alternative medicineAmfebutamoneAmineptineAnorgasmiaAntidepressantAntidepressant agentAripiprazoleArizona sexual experiences scaleArousalCitalopramClinical practiceDisease severityDistress syndromeDouble-blindDrug tolerabilityDuloxetineEjaculationErectile dysfunctionEscitalopramEuropean countriesFluoxetineFluvoxamineForced swim testHumanImipramineIndex of erectile functionMajor depressionMajor depressive disorderManagement strategiesMirtazapineMoclobemideNefazodoneOpen-labelOrgasm retardationParoxetinePatient compliancePhenelzinePhosphodiesterase v inhibitorPhysical activityPrevalencePrsexdq salsex questionnairePrsexdq-salsexPsychoeducationPsychotherapyQuality of lifeQuestionnaireReviewScoring systemSerotonin noradrenalin reuptake inhibitorSertralineSex determinationSexual behaviorSexual dysfunctionSexual encounter profileSexual functionSexual interest and desire inventory femaleSexualitySusceptible populationTesdTreatmentVaginal lubricationVenlafaxine

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Clinical Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position 36/165, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, General & Internal.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 3.46. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 17.89 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-29, the following number of citations:

  • WoS: 49
  • Scopus: 72
  • Europe PMC: 18

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-29:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 151.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 151 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 53.072.
  • The number of mentions on the social network X (formerly Twitter): 2 (Altmetric).
  • The number of mentions on Wikipedia: 4 (Altmetric).
  • The number of mentions in news outlets: 6 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Montejo Egido, Laura).

the author responsible for correspondence tasks has been Montejo Egido, Laura.