Objective:

To provide an integrated overview of sexual dysfunction associated with antidepressants and antipsychotics, focusing on mechanisms, clinical assessment, and management.

Approach:

• Review Design: Structured narrative review synthesizing mechanisms, assessment, comparative sexual tolerability, and management strategies.
• Literature Search: Search conducted on PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for relevant literature published up to May 2026.

Key Findings:

• Sexual dysfunction is common in patients with depressive and psychotic disorders and may be present before treatment.
• Strongly serotonergic antidepressants (e.g., SSRIs) are associated with higher risk of treatment-emergent sexual dysfunction.
• Prolactin-elevating antipsychotics generally have a less favorable profile regarding sexual dysfunction.
• Direct questioning and validated instruments are necessary for reliable detection of sexual dysfunction.

Interpretation:

Sexual dysfunction should be regarded as a meaningful clinical outcome in psychopharmacology, necessitating systematic assessment in treatment planning.

Limitations:

• The review is not a systematic review or meta-analysis and does not claim systematic comprehensiveness.
• No formal risk-of-bias assessment or quantitative synthesis was performed.

Conclusion:

Sexual dysfunction is a significant issue in psychotropic treatment, and understanding its mechanisms and management is crucial for patient care.