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Sexual dysfunction is a common symptom in patients with depression and a frequent, poorly tolerated side effect of antidepressants used in treating their condition. The severity of this impairment can lead to non-adherence to the very medications prescribed for these patients and interfere with their recovery.Antidepressant-associated sexual dysfunction reduces patients' quality of life and therapeutic efficacy, yet physicians may not appreciate the prevalence of this side effect and how severely it can affect treatment adherence. In untreated patients with depression, the incidence of sexual dysfunction can be very high, but estimates have varied widely depending on the assessment method used, and evaluation of global sexual dysfunction (35-45%) versus specific phases of the sexual function cycle (60-80%).This paper provides a brief overview of current sexual dysfunction assessment tools. Patient factors and anti-depressant selection affecting patient adherence are reviewed and the potential for individualized antidepressant treatment is discussed. The paper also offers potential options, including genetic identification, for managing antidepressant-associated sexual dysfunction in the hopes of improving patient adherence and treatment success.