disorder is not given. If the substance-induced sexual dysfunction occurs without a co-
morbid substance use disorder (e.g., after a one-time heavy use of the substance), no ac-
companying substance use disorder is note d (e.g., F15.981 amphetamine-induced sexual
dysfunction, with onset during intoxication).  When more than one substance is judged to
play a significant role in the development of the sexual dysfunction, each should be listed
separately (e.g., F14.181 mild cocaine use di sorder with cocaine-induced sexual dysfunc-
tion, with onset during intoxication, mode rate; F19.981 fluoxetine-induced sexual dys-
function, with onset after medication use, moderate). 
Diagnostic Features
The major feature is a disturbance in sexual function that has a temporal relationship with
substance/medication initiation, dose increa se, or substance/medication discontinuation.
Associated Features Supporting Diagnosis
Sexual dysfunctions can occur in association wi th intoxication with the following classes of
substances: alcohol; opioids; sedatives, hypnotic s, or anxiolytics; stimulants (including co-
caine); and other (or unknown) substances. Sexual dysfunctions can occur in association
with withdrawal from the following classes of substances: alcohol; opioids; sedatives, hyp-
notics, or anxiolytics; and other (or unknown)  substances. Medications that can induce sex-
ual dysfunctions include antidepressants, an tipsychotics, and horm onal contraceptives.
The most commonly reported side effect of antidepressant drugs is difficulty with or-
gasm or ejaculation. Problems with desire and erection are less frequent. Approximately
30% of sexual complaints are clinically sign ificant. Certain agents, such as bupropion and