Antidepressants And Sex Drive

Antidepressants And Sex Drive
Part of HuffPost Wellness. ©2022 BuzzFeed, Inc. All rights reserved.
Antidepressants Can Lower Your Sex Drive. Here's How To Fix It.
Experts break down everything you need to know.
Jun 1, 2018, 07:06 PM EDT | Updated Jun 5, 2018
Your brain might be to blame for your lack of sex drive.
The dip in your libido might not last.
Men are more likely to experience a change in their sex drive.
Be mindful of other factors that could get in the way.
Chat with a physician about tweaking your medication.
Above all, be honest with your doctors about the issue.
Celebrities On The Importance Of Mental Health See Gallery
Part of HuffPost Wellness. ©2022 BuzzFeed, Inc. All rights reserved.
For the more than 16 million Americans living with depression, antidepressants are often an option in providing some relief from their symptoms. However, as with any new medication, side effects are common. And that means for some, sex is impossible.
Antidepressants, particularly selective serotonin reuptake inhibitors, or SSRIs, have been shown to impact one sex’s drive ― with symptoms like reduced libido, delayed ejaculation, erectile dysfunction and an inability or delayed ability to reach orgasm. But there’s no definitive answer on how common those issues are for users. The results of studies vary widely, with the estimated of number of people affected ranging from 25 percent to 73 percent of those who take the drugs, according to Ash Nadkarni, associate psychiatrist at Brigham and Women’s Hospital in Boston.
This doesn’t mean that all hope is lost or that you should necessarily find alternative methods of mental health treatment. As with most health-related medication, knowledge is power. Below, experts break down what you need to know about antidepressants and your sex drive, and what you can possibly do about it:
Nadkarni said the potential sexual impact of SSRIs may lie in specific chemical occurrences in the brain.
“Pathways of sexual desire involve serotonin, but also chemicals such as dopamine and norepinephrine,” she said. “Dopamine is linked to the intense passion and arousal of romantic love, while norepinephrine is associated with the heightened attention and motivation of desire. Serotonin-enhancing antidepressants blunt sexual desire by reducing the capacity of dopamine and norepinephrine, or excitatory pathways, to be activated.”
Despite serotonin’s ability to lessen sexual desire, Nadkarni noted that in some instances, the chemical can also increase desire. It really varies depending on the person and the type of depression medication one is taking. For instance, some medications, including Viibryd and Wellbutrin , have been lauded for their lack of sexual side effects.
The changes antidepressants can cause in one’s sexual desire or experience of sex aren’t always permanent. It can also be difficult to determine whether depression or antidepressants are the reason for someone’s decreased sexual drive, according to John Christman, a psychiatrist at Zucker Hillside Hospital in Glenn Oaks, New York.
“When people are depressed they tend to be less social and interactive, and of course, that can have its effects in terms of libido,” Christman said. “It’s interesting because we always warn patients before starting antidepressants that one side effect of the medication can be sexual dysfunction. However in many patients their sexual performance improves because they’re less depressed.”
The sexual improvement felt by some patients beginning antidepressants isn’t necessarily the experience of all. Christman explained that sexual dysfunction is the most commonly experienced side effect of antidepressants, especially in men. Those who experience sexual dysfunction as a result of their antidepressants may consider stopping their medication, but Christman cautions against that.
“I tell most of my patients to try your best to wait it out,” he said. “If you give the medication a little bit of time, in many cases, the dysfunction will improve.”
So, what can you do about all of it? Here are a few solutions:
Sometimes, it’s not just your medication coming into play. Nadkarni said it’s important to be aware of other possible causes of sexual side effects, including age, alcohol usage, other medications or any leftover symptoms of depression.
There are multiple ways of working through any sexual side effects, including switching medications, incorporating an additional medication, or taking a day off from your medication. But this “drug holiday,” as Christman calls it, should only be done with the approval and supervision of your doctor.
“Wait the symptoms out and many times it does get better,” Christman said. “It’s very important to have conversations with your doctor if you’re experiencing side effects. Don’t feel embarrassed. Sexual activity is normal human behavior not to be stigmatized.”
Before you reconsider taking antidepressants, or attempt to stop using them if side effects arise, you should speak with your physicians who prescribed you the medication.
Those on antidepressants and experiencing a decreased sex drive also may want to consider speaking with a sex therapist.
“I suggest joint couples or sex therapy sessions (separate from the person with depression’s personal therapy) so you can feel like you’re both being heard, and so you can work together as a team on your sex life,” sex therapist Vanessa Marin said. “The tricky thing about these situations is that you have to make the space for both of your experiences. It’s understandable for the person with depression to be disinterested in sex, and it’s understandable for the partner to still want sex. You may have to be patient for a while, and you may have to get creative about other ways to experience intimacy and sexual satisfaction.“
How you choose to address any side effects that might arise from taking a depression medication remains up to you. And keep in mind that not every person will have the same experience.
“If you do have the side effects sometimes with time it will go away, and if it still doesn’t go away there are things you can do,” Christman said. “Not everybody gets the side effects, and you should not let the sexual side effects be a stumbling block in seeking treatment. It’s something to be discussed with your doctor, and it’s something you can treat together.”

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SAMe: (s-adenosylmethionine) Some studies show it can help and may be as effective as antidepressants. 5-HTP : (5-hydroxytryptophan) A popular over-the-counter precursor to serotonin that has not, as yet, been well-established as a safe and effective treatment for depression Omega-3 fatty acids: Good for your heart and promising for depression, but not yet recommended Valerian: There is no evidence that this helps depression. Kava: Also unproven, and possibly dangerous for your liver

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Antidepressants can be a powerful tool for treating depression and anxiety . But some men may fear that making use of these medications could put their sex life in jeopardy. Sexual side effects from these drugs are common – they can cause problems related to ejaculation (it’s delayed or impossible) and weak libido.
It can take at least a couple of weeks for depression medicine to kick in -- and up to 12 weeks for you to tell if it's really working. You and your doctor may have to experiment to find the right dose, the right drug, or even the right combination of medicines. Don't give up. Studies show that many adults with depression are likely to find medicine that helps.
You can't get addicted to antidepressants, but you may have withdrawal-like symptoms if you stop taking some antidepressants too quickly. Quitting suddenly could give you headaches, muscle aches, an upset stomach, or other problems. Don't stop unless your doctor tells you to. And they'll give you a schedule of how to taper off slowly.
Ask your doctor when to take your medicine, whether to take it with food, and if you should skip taking other medicines or foods at the same time. Even vitamins, supplements, and non-prescription medicines like cough syrup can affect antidepressants. Ask what to do if you miss a dose: Take it as soon as you can or wait until the next scheduled dose?
Many side effects go away within a week or 2, but others may be a sign you need to adjust what you're taking. Look for insomnia, nausea, weight gain, dizziness, and sexual problems. Keep track of any issues so you can help your doctor fine-tune your treatment. If you ever have thoughts of suicide, talk to your family or doctor right away.
Depression usually has a mix of physical, emotional, and mental symptoms. Studies show that the most effective way to treat depression is a combination of medicine and therapy. Options range from counseling, like cognitive therapy, to meeting with a support group. Learning to cope with the conflicts, traumas, losses, or stresses that trigger your illness can help keep you well.
Work on your physical as well as emotional strength. Exercise can ease depression symptoms, especially when you do things that get your heart rate up. In fact, exercise can sometimes work as well as antidepressants for people with mild to moderate depression. It helps to ease stress and gives you a sense of well-being. Exercise helps you feel better right away. And when you stick with it, those feelings last.
Eating the right foods helps your body work at its best. And when your body is in good shape, your treatment works well. Not getting enough of some vitamins and minerals can make depression worse. And research shows that foods that are bad for your heart -- like saturated fats -- may even increase your risk for developing depression. Also, limit your alcohol intake or avoid it altogether if you and your doctor think alcohol use is a problem.
Getting enough sleep boosts your mood and helps you cope with stress. In fact, most people with depression have sleep problems. To sleep better, exercise, have a regular meal and bedtime schedule, limit caffeine and alcohol, get outside during daylight, and have a relaxing bedtime routine.
Nontraditional or alternative treatments may relieve some symptoms, help you relax, and ease problems like physical pain or anxiety that make depression worse.
People who are low on vitamin D seem more likely to get depressed, but taking extra D doesn't always help them feel better. Some studies show that EPA (eicosapentaenoic acid), found in fish oil, may help treat depression. L-methylfolate (Deplin) -- shows promise for boosting the benefits of antidepressants in some patients. Talk to your doctor to see if it's right for you.
The ancient herb St. John's wort is often prescribed for depression in Europe. Many studies have shown it can help as much as medicine for milder cases. But it doesn't seem to work for serious depression. It can also interact with antidepressants, so talk to your doctor before using it.
Reviewed by Smitha Bhandari on 17.12.2020
But there’s good news: Most men can get relief from sexual dysfunction that’s caused by antidepressants while continuing to take medication. “It’s generally a very solvable issue,” said psychiatrist David J. Hellerstein, MD, of Columbia University.
We spoke with Dr. Hellerstein, along with three other experts – psychiatrist David Healy, MD, of McMaster University, pharmacist Benjamin Chavez, PharmD, of the University of Colorado, and pharmacist Sarah T. Melton, PharmD, of East Tennessee State University – to learn more about how men can take antidepressants without damaging their sex life.

The Solution Could Be as Simple as a Dose Change

“Patients often go on Google, type in ‘sexual dysfunction,’ and immediately jump to a conclusion about their problem. In fact, there are a lot of medical causes for sexual dysfunction, such as depression, anxiety disorders, and substance abuse. We’ve seen people who’ve told us that their sexual function improves while on an antidepressant, probably because their loss of function was a severe symptom of their depression.
Talk to your psychiatrist or physician and try to sort it out. Don’t stop your treatment or make changes, which can lead to bigger problems. Sometimes the sexual dysfunction improves over time as the body adjusts. And one of the simplest things to do is to adjust the dose of the medication [under the guidance of your doctor] – lowering it, skipping a dose, or taking it later in the day.” – David J. Hellerstein, MD

Some Antidepressants Are Riskier Than Others

"Two classes of antidepressants are associated with the highest level of occurrence of sexual dysfunction.
One group is the selective serotonin reuptake inhibitors (SSRIs) – citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). Paxil is considered to be the most problematic. In fact, it’s considered the drug of choice for premature ejaculation in order to prolong time to orgasm.
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