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The popular medications known as selective serotonin reuptake inhibitors or SSRIs (see box) can help lift people out from under a dark cloud of depression. But there are some side effects from antidepressants , including those that can affect your sex life. In addition to reducing interest in sex, SSRI medications can make it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren't able to have an orgasm at all. These symptoms tend to become more common with age.
If you experience any sexual problems while taking an SSRI medication, talk with your doctor or therapist. About 35% to 50% of people with untreated major depression experience some type of sexual dysfunction prior to treatment. So, in some cases, sexual difficulties may stem not from the SSRI, but rather from the underlying depression. If medication is the problem, sexual side effects sometimes subside with time, so it's worth waiting a while to see if problems diminish. This is a particularly good strategy if the medication is easing your depression significantly. But if side effects from antidepressants persist, your doctor or therapist may suggest one of the following strategies, as found in the Harvard Special Health Report Understanding Depression :
Lowering the dose. Sexual side effects may subside at a lower, although still therapeutic, dose.
Scheduling sex. Your medication may produce more pronounced side effects at particular times of the day, for example, within a few hours of taking it. If so, you can try scheduling sexual activity for the time when side effects are least bothersome—or take the drug at a different time.
Taking a drug holiday. Depending on how long the drug usually remains in your body, you might stop taking it for a few days—for example, before a weekend, if that's when you hope to have sex. This isn't spontaneous, but it can work if you carefully follow your doctor's directions about how to stop and resume your medication. However, there is always a chance that this might cause a relapse, especially if it is one of the drugs that leaves your system relatively rapidly.
Switching to a different drug. Certain antidepressants, such as bupropion (Wellbutrin), and mirtazapine (Remeron) are less likely to cause sexual problems. Bupropion, which affects both norepinephrine and dopamine, can sometimes improve sexual response.
Adding a drug. For some men, taking sildenafil (Viagra) or tadalafil (Cialis) can alleviate SSRI-induced erectile dysfunction . Both men and women may benefit from adding bupropion to their treatment. This medication has been found to counter SSRI-induced sexual dysfunction, boost sexual drive and arousal, and increase the intensity or duration of an orgasm. In some people, the anti-anxiety drug buspirone (BuSpar) may help increase libido and restore the ability to have an orgasm.
Meeting with a therapist. Even when physical issues or medication are at the root of sexual problems, psychological issues often become interwoven. For example, a few episodes of erectile dysfunction may cause a man to withdraw from sex and his partner to feel rejected. These issues can lead the couple to retreat further from intimacy. Working with a sex therapist or general therapist can help couples explore their sexual concerns, learn to better communicate, and expand their repertoire of sexual activities.
– By Julie Corliss
Executive Editor, Harvard Heart Letter
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
The physical transformations the body undergoes with age have a major influence on sexuality. This Special Health Report, Sexuality in Midlife and Beyond , will take you through the stages of sexual response and explain how aging affects each. You’ll also learn how chronic illnesses, common medications, and emotional issues can influence your sexual capabilities. Finally, you’ll find a detailed discussion of various medical treatments, counseling, and self-help techniques to address the most common types of sexual problems.
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SSRI medications include
citalopram (Celexa)
escitalopram (Lexapro)
fluoxetine (Prozac)
fluvoxamine (Luvox)
paroxetine (Paxil)
sertraline (Zoloft)
vortioxetine (Trintellix, formerly called Brintellix).
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Published January 27, 2015 12:00AM (EST)
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The other day, I found myself in bed with my Hitachi counting off orgasms. One. Two. Three. Four. Five. Six. All in under 30 minutes. Not too long ago, it would have taken me at least that long to have just one. I kept going just because I could. I felt like the Cookie Monster of climax — my googly eyes rolling around in my head while I barked, "Me want orgasm!" It may or may not have occurred to me at one point to get out a stopwatch. I sort of wanted to call a friend about my newfound orgasmability. I kind of wanted to tweet about it.
The secret to this surprise sexual awakening? A couple of months ago, I stopped taking Prozac.
I went on antidepressants not too long after my mom was diagnosed with terminal cancer. It was my second experience with antidepressants, but also by far my longest. There was just so much to endure for so long — the diagnosis, the illness, the years of uncertainty waiting for something we didn't want to happen and then the grieving when it did. All in all, more than four years. So when I decided to go off Prozac, I couldn’t even meaningfully remember what anything was like before it....
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Do you just take the wellbrutin when you are planning to get intimate?
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By
flomelly ,
January 24, 2009 in Prozac (fluoxetine)
This is my first post on any forum so please bear with me.
My boyfriend has been on fluoxetine for 3 months now and the major side effects that are getting him down are waking up every couple of hours in the night therefore waking up shattered all the time, and the inability to orgasm. He is talking about coming off it as he is struggling with the inability to orgasm. He hasn't lost his sex drive at all he is still as horny as ever and he has no problem getting aroused :-) he is just frustrated as no matter what we have tried he can not orgasm with me. We are very open and we can talk about everything and he has told me that he has managed to come by himself but it takes him forever and a day. The fluoxetine seems to be helping him with the depression but I am worried that if this problem doesn't fade or go away he is going to come off them. Has anyone got any advice regarding this or any similar experiences. He is hoping it subsides after a while and I am too. He is worried I am going to leave him if we can't have the good sex life we used to have, he already wonders how I put up with him as he can be really hard to be with at times because of his mood swings. I have assured him I am going nowhere but when you are depressed I don't think you see things like that.
My boyfriend has been on fluoxetine for 3 months now and the major side effects that are getting him down are waking up every couple of hours in the night therefore waking up shattered all the time, and the inability to orgas
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