American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which antidepressant is noted for causing sexual side effects?

Fluoxetine
Bupropion
Sertraline
Paroxetine

The correct answer is: Bupropion

Bupropion is particularly noted for its minimal sexual side effects compared to other antidepressants. It is a dopamine and norepinephrine reuptake inhibitor, which is different from selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine. SSRIs are known to commonly cause sexual side effects, such as decreased libido, delayed ejaculation, and anorgasmia, due to the increased serotonin levels in the brain affecting sexual functioning. In contrast, bupropion often provides an alternative for patients who experience sexual dysfunction with SSRIs. It may even be used to counteract these side effects when they occur with SSRIs. Given this pharmacological profile, bupropion is seen as a more favorable option for those concerned about sexual dysfunction associated with antidepressant therapy. In summary, while other options mentioned in the question are linked with a higher incidence of sexual side effects, bupropion is recognized for generally having a lower risk in this regard.