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SSRI Side Effects - Sexual Dysfunction — UKMLA MCQ

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HardPsychiatrySSRI Side Effects - Sexual DysfunctionUKMLAMRCGP AKTPARAPSA

A patient in remission from recurrent depression has troublesome SSRI-related sexual dysfunction. She has a high relapse risk and asks whether she should stop treatment today. Which response best reflects NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Discuss sexual effects and relapse risk, then agree continuation or a taper

C is correct. NICE advises discussing the possible long-term harms of continuing antidepressants, including effects on sexual function, and balancing these against the individual's risk of relapse. The decision should be shared and reviewed rather than automatic in either direction. If she chooses to stop, the dose should usually be reduced in stages with monitoring for withdrawal and recurrence; abrupt cessation is inappropriate. Alternate-day dosing is not a universal tapering method and can provoke fluctuations with shorter half-life drugs. Adding another antidepressant without reviewing benefit, harms, interactions and the patient's preferences is also not a safe default.

Reference: NICE NG222, recommendations 1.4.10 to 1.4.18 and 1.8.3 to 1.8.5: https://www.nice.org.uk/guidance/ng222/chapter/recommendations