A 25-year-old man with major depression ' discusses the potential benefits and side effects of various antidepressants with his psychiatrist. He clearly indicates that he does not want a medication that could decrease his libido or interfere' with his ability to obtain and maintain an erection. Which of the listed antidepressants would be appropriate for this patient?

Tricyclic antidepressants such as clomipramine and amitriptyline and SSRIs such as paroxetine and sertraline, as well as MAOIs, can cause erectile dysfunction, delayed ejaculation, anorgasmia, and decreased libido. Buproppion, mirtazapine, trazodone, and nefazodone, in contrast, do not affect sexual functions in a negative way Trazodone and nefazodone, however, have been implicated in cases of priapism and should not therefore be used as first-line medications in male patients.