Rates of antidepressant-associated treatment emergent changes in sexual function and satisfaction vary with method of ascertainment. We used the Rush Sexual Inventory (RSI) to assess the effect of SSRIs on sexual function and satisfaction. The RSI is a comprehensive, succinct, patient-rated scale designed to provide an accurate depiction of premorbid, current, and followup changes in sexual function and satisfaction. We assessed 42 outpatients, diagnosed with major depressive disorder with or without comorbid obsessive-compulsive disorder, over their first 8 weeks of treatment with paroxetine 20 mg/day, sertraline 50-200 mg/day, or fluoxetine 20-60 mg/day. Males and females were found to experience similar rates of treatment emergent sexual dysfunction at 60 percent and 57 percent, respectively. Despite the same mechanism of action, medication treatment groups experienced varying levels of changes in sexual function and satisfaction over time. No variation existed between responders and nonresponders over time.