Although it shares monoaminergic activity with other antidepressants, in contrast to them pimavanserin does not exhibit adrenergic, histaminergic, muscarinic, or dopaminergic activity (Vanover et al., 2006), to which sexual dysfunctions are attributed (Serretti and Chiesa, 2009), and the specific 5-HT2 antagonism may even improve sexual functioning. This evidence concerns the gene HTR2A and sexual dysfunction.