OBJECTIVES: Newer antidepressants selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed antidepressants. This is due mostly to their better side effect profile when compared to older drugs like tricyclic antidepressants (TCAs). However these classes are not completely bereft of side effects.  Psychosexual dysfunction is a condition that occurs commonly among depressed patients. It has been shown to be associated with antidepressant. The objective of our study is to compare the incidence of psychosexual dysfunction between TCAs, SSRIs, and SNRIs. METHODS: We used a cohort study design in an administrative claims database (2006-2013 Lifelink claims data) to compare the incidence of psychosexual dysfunction in TCAs, SSRIs, and SNRIs. Incidence was reported per 10,000 person-years. The Cox proportional hazard model was used to assess the risk of adverse events while adjusting for potential confounders. RESULTS: A total of 269489 patients with an incident prescription for a TCA, SSRIs or SNRIs were identified and met the study inclusion criteria. They constituted a total of 682,657 person years. The unadjusted hazard ratio of incidence of psychosexual dysfunction in patients on SNRIs compared to SSRIs was 1.625 (1.506-1.755). The results were consistent after adjusting for various covariates using the Cox proportional hazards model.  The hazard ratio for the full model was 1.429 (1.323-1.545) and for the reduced model with covariates identified using stepwise regression was 1.431(1.325-1.546). The directionality of covariates adjusted for in the analysis was consistent with current literature. CONCLUSIONS: SNRIs were associated with a greater risk of psychosexual dysfunction than SSRIs.