title: The use of monoamine pharmacological agents in the treatment of sexual dysfunction: evidence in the literature.
abstract: BACKGROUND
  The monoamine neurotransmitters serotonin, dopamine, and norepinephrine play an important role in many medical and psychological conditions, including sexual responsiveness and behavior. Pharmacological agents that modulate monoamines may help alleviate sexual dysfunction.
  
  
  OBJECTIVE
  To provide an overview of pharmacological agents that modulate monoamines and their use in the treatment of sexual dysfunction.
  
  
  METHODS
  EMBASE and PubMed search for articles published between 1950 and 2010 using key words "sexual dysfunction,""monoamines,""monoaminergic receptors," and "generic names for pharmacological agents."
  
  
  METHODS
  To assess the literature evaluating the efficacy of monoamine pharmacologic agents used in the treatment of sexual dysfunction.
  
  
  RESULTS
  The literature primarily cites the use of monoaminergic agents to treat sexual side effects from serotonergic reuptake inhibitors (SSRIs), with bupropion, buspirone and ropinirole providing the most convincing evidence. Controlled trials have shown that bupropion improves overall sexual dysfunction, but not frequency of sexual activity in depressed and nondepressed patients. Nefazodone and apomorphine have been used to treat sexual dysfunction, but their use is limited by significant side effect and safety profiles. New research on pharmacologic agents with subtype selectivity at dopaminergic and serotonergic receptors and those that possess dual mechanisms of action are being investigated.
  
  
  CONCLUSIONS
  There has been tremendous progress over the past 50 years in understanding the role of monoamines in sexual function and the effect of pharmacologic agents which stimulate or antagonize monoaminergic receptors on sexual dysfunction. Nevertheless, large, double-blind, placebo-controlled studies evaluating the efficacy of currently available agents in populations without comorbid disorders are limited, preventing adequate interpretation of data. Continued research on sexual function and specific receptor subtypes will result in the development of more selective pharmacologic agents with the goal of increasing efficacy without the dose-limiting side effects of nonselective agents.
authors.affiliation: Department of Clinical Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Moll
authors.forename: Candace S
authors.initials: CS
authors.lastname: Brown
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001058:Apomorphine / Q000627:therapeutic use*; D015306:Biogenic Monoamines / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006801:Humans; D010879:Piperazines; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy*; D019529:Sexuality / Q000187:drug effects*; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015306:Biogenic Monoamines; D000697:Central Nervous System Stimulants; D018491:Dopamine Agonists; D010879:Piperazines; D014230:Triazoles; C051752:nefazodone; D001058:Apomorphine