When antidepressant medicine is used to treat depression, it may cause sexual dysfunction. The primary sexual dysfunction is delay of orgasm, but a variety of other side effects may occur.
Your sexual response consists of 5 phases:
Brain chemicals control your sexual response, so any drugs or conditions that alter your brain chemistry can alter your sexual response. Dopamine is a type of brain chemical known as a neurotransmitter. Dopamine is important for pleasure and reward, and an increase in dopamine activity may enhance the sexual response. Conversely, blocking dopamine may compromise the response.
Serotonin is a neurotransmitter present in significant quantities in areas of the brain responsible for feelings and emotion. Low serotonin levels can lead to depression and other conditions. The idea behind widely prescribed medicines, such as fluoxetine, paroxetine, and sertraline, is to keep levels of serotonin circulating longer by preventing its uptake and breakdown. But at the same time that these drugs are increasing serotonin activity and relieving depression, sexual response may be diminished.
Sexual function is an important component for quality of life and can be affected by antidepressant treatment. Do not feel embarrassed if you experience sexual dysfunction. You should report changes in sexual functioning to your doctor and discuss treatment. However, it is important that you do not stop taking your medicine without consulting your doctor.
Sexual dysfunction may not be a huge issue for patients receiving short-term antidepressant treatment. However, inadequate sexual functioning can offset the antidepressive benefits of long-term treatment. Sexual difficulties could theoretically cause patients to stop treatment and relapse into a deep depression.
There are numerous treatment options if your medicine does cause sexual dysfunction. They include decreasing the dosage, taking drug "holidays," adding another drug to counteract the problem, or switching to another drug. However, all of these changes should be prescribed and supervised by a doctor. Results vary from person to person. And some of these options may be successful in treating antidepressant-induced sexual dysfunction in certain individuals but not others. Talk to your doctor about the best treatment approach for you.
There are some antidepressant medicines that provide short- and long-term medical benefits that do not have sexual side effects, but may have other significant ones. These include:
Discuss your symptoms with your doctor. It may seem embarrassing to talk about sexual problems, but doctors recognize that antidepressants commonly affect sexual health. Your doctor will be receptive to talking about this sensitive topic.
Herb Research Foundation
Mental Health America
Canadian Network for Mood and Anxiety Treatment
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Rosen RC, Lane RM. Effects of SSRIs on sexual function: a critical review. J Clin Psychopharmacol. 1999 Feb;19(1):67-85.
Understanding sexual pleasure. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/sex-101/understanding-sexual-pleasure-23902.htm. Accessed July 19, 2016.
Last reviewed July 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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