Antidepressants Increase Sex Drive
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Antidepressants Increase Sex Drive
Published January 14, 2015 1:50am EST
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The antidepressant bupropion may hold promise for improving symptoms in younger women diagnosed with so-called hypoactive sexual desire disorder, a small study suggests.
The disorder, called HSDD for short, is diagnosed when a person has a persistently low interest in sex, and that disinterest is causing personal distress or relationship problems.
In the new study, Iranian researchers found that bupropion sustained-release (Wellbutrin SR) generally boosted sex drive among 116 women with HSDD who took the drug for 12 weeks. Compared with 116 women given an inactive placebo, their scores on a standard measure of sexual function were twice as high, according to findings published in the medical journal BJU International.
In some cases, low sex drive is related to underlying health conditions, like depression, or to side effects from some medications, like high blood pressure drugs or some antidepressants.
HSDD, however, refers to low sex drive that is not better accounted for by depression or other mental health disorders, and not caused by a medical condition or drug side effect.
As it stands, there is no treatment for HSDD that is widely accepted by women, according to the researchers on the new study, led by Dr. Mohammad Reza Safarinejad of Shahid Beheshti University in Tehran.
In Europe, a testosterone patch called Intrinsa is approved for treating HSDD in postmenopausal women. It is not approved in the U.S.
In an email, Safarinejad noted that studies have shown bupropion SR to improve sexual function in women who are having sexual side effects from using other antidepressants known as selective serotonin reuptake inhibitors (SSRIs).
Decreased libido is a potential side effect of SSRIs, which include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac). Bupropion has a different mechanism of action from SSRIs, targeting the nervous system chemicals dopamine and norepinephrine rather than serotonin.
For the current study, Safarinejad and colleagues randomly assigned 232 women between the ages of 20 and 40 to take either bupropion SR or a placebo every day for 12 weeks. All of the women had been diagnosed with HSDD and were free of depression or other major health problems.
The study received no drug industry funding, Safarinejad said.
At the outset, both groups of women had similar scores on a standard questionnaire gauging sexual function — just under 16, on average. The average score for healthy women with a regular partner is 33.6, Safarinejad said.
After 12 weeks, that score improved to 33.9 among women in the antidepressant group, versus 16.9 in the placebo group.
The most common side effects linked to bupropion included headache (affecting 9 percent of the group), insomnia and dry mouth (each affecting 7 percent), and nausea and muscle aches (each affecting 6 percent).
While the findings suggest that bupropion improves low sex drive, this is the first study to test the antidepressant in premenopausal women with HSDD.
"Further studies are needed to better elucidate the role of bupropion in HSDD," Safarinejad noted.
Exactly why bupropion might improve sexual function is unclear. One theory attributes the effects to enhanced dopamine and norepinephrine activity; research suggests that dopamine is a key player in the brain's "pleasure center," being released in response to "rewards" like food and sex.
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THE LIST - SO WHICH IS THE BEST DEPRESSION MED FOR SEX DRIVE?
Typical dose of moclobemide is >300 mg / day.
The medication is generally well-tolerated.
5.) Mirtazapine/Remeron : Classified as an 'atypical anti-depressant' and specifically as a noradrenaline and serotonin system modulator, a complex mechanism of action involving alpha-2-blockade and downregulation [36] [37] and serotonin 5-HT2A/2C blockade; leading to enhancement of frontal dopamine/noradrenaline release.
Though sedating at low doses (15 mg), Remeron's antidepressant benefits become more apparent at doses of >30 mg up to 45 mg and 60 mg being maximum dose [38] .
The benefits of this drug are many, it has beneficial effects on stress hormones , lowers cortisol/ACTH and decreases Prolactin levels . It may even increase longevity and have anti-aging effects on the cardiovascular system and on cells in general. It can be used for libido and general strength & Vigor.
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Hello. Have you tried lobelia? Is it different with bupropion? Seems to have effect on a4b2 nAchr, DAT and VMAT2.
I have not tried Lobelia, in fact, don't smoke either. :D
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Posted November 1, 2012
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Depression is a very common, potentially fatal illness ( suicide ). Antidepressants usually help, but they have a distressing downside, sexual side effects: loss of erotic interest, arousal and erection problems, and particularly trouble having orgasms. Fortunately, one antidepressant rarely causes sexual side effects, Wellbutrin (bupropion).
Wellbutrin is just as effective as the most popular class of antidepressants, the SSRIs (Prozac, Paxil, Zoloft, Celexa, Lexapro, Luvox). Its nonsexual side effects are no worse, and it’s unlikely to cause sexual side effects. But doctors rarely prescribe it. Therein hangs a tale of bad luck and drug company prudery in the era before Viagra.
In the mid-1980s, North Carolina-based Burroughs-Wellcome (now Glaxo Wellcome) contracted with several laboratories to study Wellbutrin’s side effects in hopes of winning Food and Drug Administration approval. One study raised a red flag. At high doses, Wellbutrin’s original formulation triggered seizures in four-tenths of 1 percent of users, four people per 1,000. That’s not many, but it was three times the seizure risk of other antidepressants, and the FDA has nightmares about car wrecks caused by seizures behind the wheel. The study results were reported in the medical press, and suddenly, doctors viewed Wellbutrin as too risky to prescribe.
Burroughs-Wellcome scrambled and came up with a new slow-release (SR) formulation that causes seizures in only one-tenth of 1 percent of users, comparable to the seizure risk of Prozac and Paxil, and lower than the risk associated with Zoloft, Luvox, and Celexa. But the damage was done. Wellbutrin was tainted, and despite a massive advertising campaign, doctors did not change their minds. (The name, Wellbutrin, was so toxic that when the drug was shown to help smokers quit, it was released under a different name, Zyban.)
Meanwhile, around the time of the seizure scare, a dozen years before Viagra’s approval, Burroughs-Wellcome also contracted with a noted sex researcher, Theresa Crenshaw, M.D., (now deceased) to investigate Wellbutrin’s side effects. Crenshaw, the coauthor of the medical text, Sexual Pharmacology, found that it caused fewer sexual side effects than other antidepressants—and that some users reported sexual enhancement. “Our study,” Crenshaw told me in an interview shortly before her death, “was the first well-controlled clinical trial to demonstrate an improvement in sexual function due to drug treatment.”
An astonished Crenshaw rushed to tell Burroughs-Wellcome that Wellbutrin was more than just another antidepressant. It was a potential bonanza, a pill that, for some, improved sex. Oddly, Burroughs-Wellcome showed no interest. Or not so oddly. Before Viagra, the drug industry had always steered clear of anything sexual. In Crenshaw’s words, “They were prudes.”
Wellbutrin languished both on pharmacy shelves and as a focus of research. But in the mid-1990s, low-libido became recognized as a problem, and researchers showed renewed interest in Crenshaw’s earlier report. Several more studies showed that Wellbutrin caused fewer sexual side effects than SSRIs, and that SSRI users who also took some Wellbutrin reported fewer sexual side effects and better sexual functioning.
If you’re currently taking an SSRI and suffering sex problems because of it, ask your doctor about the possibility of switching to Wellbutrin. Or ask about taking a low dose of Wellbutrin (75 mg) in addition to your SSRI two hours before sex. Unfortunately, few doctors know that Wellbutrin is an effective substitute for SSRIs, one that causes few sexual side effects and may even enhance sexual satisfaction.
If you switch to Wellbutrin, or add it to your treatment regimen, the only unusual side effects are somewhat more risk of tremor, which can be scary. Fortunately, after a few months, tremors usually subside.
Ashton, A.K. et al. “Bupropion as an Antidote for Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction,” Journal of Clinical Psychiatry (1998) 59:12.
Clayton, A.H. et al. “A Placebo-Controlled Trial of Bupropion SR as an Antidote for Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction,” Journal of Clinical Psychiatry (2004) 65:62.
Crenshaw T.L. et al. “Pharmacologic Modification of Psychosexual Dysfunction,” Journal of Sex and Marital Therapy (1987) 13:239.
Demyttenaere, K. and L. Jaspers. “Review: Bupropion and SSRI-Induced Side Effects,” Journal of Psychopharmacology (2008) 22:792.
Labbate, L.A. et al. “Bupropion Treatment of Serotonin Reuptake Antidepressant-Associated Sexual Dysfunction,” Annals of Clinical Psychiatry (1997) 9:241.
Modell, J.G. et al. “Effect of Bupropion SR on Orgasmic Dysfunction in Nondepressed Subjects: A Pilot Study,” Journal of Sex and Marital Therapy (2000) 26:231.
Modell, J.G. et al. “Comparative Sexual Side Effects of Bupropion, Fluoxetine, Paroxetine, and Sertraline,” Clinical Pharmacology and Therapeutics (1997) 61:476.
Rowland, D.L. et al. “Bupropion and Sexual Function: A Placebo-Controlled Prospective Study of Diabetic Men with Erectile Dysfunction,” Journal of Clinical Psychopharmacology (1997) 17:350.
Safarinejad, M.R. “Reversal of SSRI-Induced Female Sexual Dysfunction by Adjunctive Bupropion in Menstruating Women: A Double-Blind, Placebo-Controlled, Randomized Trial,” Journal of Psychopharmacology (2010) epub ahead of print.
Seagraves, R.T et al. “Buproion Sustained Release for the Treatment of Hypoactive Sexual Desire Disorder in Premenopausal Women,” Journal of Clinical Psychopharmacology (2004) 24:339.
Seagraves, R.T. et al. “Bupropion SR for Treatment of Hypoactive Sexual Desire in Nondepressed Women,” Journal of Sex and Marital Therapy (2001) 27:303.
Michael Castleman, M.A. , is a San Francisco-based journalist. He has written about sexuality for 36 years.
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I'm worried about the sexual side effects from antidepressants. What can be done to prevent or reduce such side effects?
Answer From Daniel K. Hall-Flavin, M.D.
Taylor MJ, et al. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database of Systematic Reviews. 2013; doi:10.1002/14651858.CD003382.pub3.
Baldwin DS, et al. Impact of antidepressant drugs on sexual function and satisfaction. CNS Drugs. 2015; doi:10.1007/s40263-015-0294-3.
Chokka PR, et al. Assessment and management of sexual dysfunction in the context of depression. Therapeutic Advances in Psychopharmacology. 2018; doi:10.1177/2045125317720642.
Montejo AL, et al. Sexual side-effects of antidepressant and antipsychotic drugs. Current Opinion in Psychiatry. 2015; doi:10.1097/YCO.0000000000000198.
Lorenz T, et al. Antidepressant-induced female sexual dysfunction. Mayo Clinic Proceedings. 2016; doi:10.1016/j.mayocp.2016.04.033.
Kovich H, et al. Common questions about the pharmacological management of depression in adults. American Family Physici
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