Antidepressants That Don't Affect Libido
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Antidepressants That Don't Affect Libido
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Depression is a common mental health problem that is often treated by a class of medication called serotonin-specific reuptake inhibitors, or SSRIs. Examples of SSRIs include fluoxetine--Prozac--and sertraline--Zoloft. This group of medications may cause the side effect of sexual dysfunction, including a loss of libido, or sexual drive. However, there are several antidepressant medications that do not generally cause a change in libido; these may be preferred by patients being treated for depression who are worried about changes in their sexual function.
Bupropion, sometimes known by its brand name, Wellbutrin, is an antidepressant that is categorized as a dopamine reuptake inhibitor--it increases the amount of dopamine available within the brain by blocking its ability to be reabsorbed. The exact mechanism of action of burpropion is unclear. It is thought that by inhibiting the reuptake of both dopamine and another brain chemical, norepinephrine, symptoms of depression improve.
Side effects relating to sexual dysfunction do not occur; however, headaches, weight loss and nausea may be potential side effects that patients should be aware of when taking this medication.
Mirtazapine is another kind of antidepressant medication. It is thought to work by blocking a type of cell receptor known as the alpha-two receptor. This blockade causes an increase in the amounts of both serotonin and norepinephrine neurotransmitters; these are both chemicals within the brain which are thought to be associated with depression.
According to The National Institutes of Health website, Medline Plus, sexual side effects, such as a loss of libido, do not occur while taking this medication, but patients may feel dizzy, anxious or confused. Somnolence, or excessive sleepiness, occurs in more than half of patients taking this medication. Constipation, nausea, and vomiting may also occur. In very rare cases, heart problems and seizures may occur.
Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor--it blocks the reuptake, or absorption, of both serotonin and norephinephrine. This medication is another possibility for patients who are experiencing side effects from SSRI medications.
While sexual dysfunction may occur, loss of libido is a rare side effect; according to the medical reference "UpToDate," only about 5 percent of patients will experience this unpleasant effect. More commonly, venlafaxine causes headache; dizziness; insomnia or its opposite, excessive sleepiness; and nausea. This latter side effect is especially common with venlafaxine, occurring in nearly two-thirds of patients who are taking this medication.
Published October 26, 2015 6:32pm EDT
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It’s hard to feel sexy when you don’t feel happy. If that unhappiness is rooted in clinical depression, your health care provider may recommend an antidepressant.
But it’s vital that you know all of the possible side effects before you sign on – because like most other medications, not all of them are created equal.
In fact, antidepressants in the SSRI family (selective serotonin reuptake inhibitors) are known to cause low libido. Prozac, Zoloft , Celexa and Paxil are all SSRIs and all have been documented as having sexual side effects.
Dr. Chad Collom, a doctor of nursing practice and board-certified family psychiatric mental health nurse practitioner at Solace Counseling in Dallas, Texas, explains why.
“SSRIs stimulate certain serotonin receptors that can cause a decrease in dopamine and norepinephrine in an area of the brain, which can have an effect on libido,” Collom said. “Older classes of antidepressants that are not used as much anymore, like monoamine oxidase (MAOIs) and tricyclics antidepressants (TCAs), can have the same libido depressing effect.”
Of course, depression itself can cause low libido. In fact, it’s very common in people battling depression – and this presents a bit of a Catch-22.
“The risks versus benefits should be weighed,” Collom explained. “If depression is causing significant impairment in one's life, then treatment may be necessary. This should be determined with your health care professional.”
So, is there anything you can do to combat the low libido caused by antidepressants?
“For men, some medications such as Levitra, Viagra , and Cialis can be of some benefit,” Collum said.“Men should also get testosterone levels checked. Though (it’s) not indicated for women, some studies using Viagra in women have shown positive results with sexual side effects. Women should always get hormone levels checked.”
There’s another option as well, Collom noted.
“Changing to Wellbutrin (another antidepressant that works only on dopamine and norepinephrine receptors) or adding it to an SSRI can help counteract sexual side effects,” he said.
In other words, not all antidepressants have sexual side effects.
“Wellbutrin has been shown to have no sexual side effects due to its mechanism of action,” Collom said. In fact, “Wellbutrin can actually increase one’s sex drive.”
According to Collom, the key to dealing with antidepressants and the risk of sexual side effects is to “Always consult with your health care provider to get treatment options that will be the best fit for your symptoms of depression. Giving your provider a detailed history is essential in order to give him or her a clear and accurate picture leading to a treatment plan that’s right for you.”
Symptoms of depression are not something that should be ignored. So, don’t let this information keep you from seeking help from your health care professional. Instead, use it to prepare yourself when you do seek help. The more you know, the better.
A happy and healthy sex life starts with being informed and seeking professional care when you need it.
And don’t ever be afraid to ask questions. Your health care professional is there for you.”
Jenny Block is a freelance writer based in Dallas, Texas. She is the author of " Open: Love, Sex, and Life in an Open Marriage ." Her work also appears in " One Big Happy Family " edited by Rebecca Walker and " It’s a Girl: Women Writers on Raising Daughters " edited by Andrea Buchanan. Visit her Web site at www.jennyonthepage.com.
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