Citalopram (Celexa) is widely used in the United States. This medicine is FDA approved for treatment of depression. Some doctors may prescribe citalopram to treat other psychiatric conditions also. While Celexa is effective in treating these major depression, it has been associated with sexual problems.
Citalopram is one of a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medicines work by increasing the activity of the brain chemical serotonin, which helps regulate mood.
Men or women may experience sexual side effects, such as:
It is not yet clear how SSRIs affect sexual function. The effects are believed to be related to the increased level of serotonin, which may affect sexual reflex centers.
There are a number of alternative treatment options available if you are dissatisfied with your sexual functioning while taking citalopram. But, it is important to talk with your doctor about your concerns first. Although it can be very difficult and embarrassing to discuss your sexual functioning, it is crucial that you communicate with your doctor about it. Never make any changes to your medicine regimen or start taking new medicines or herbal supplements without your doctor’s knowledge and approval. Here are some possibilities that you and your doctor may decide to have you try:
As you adjust to your new medicine, the sexual side effects may go away.
This tactic may work, but carries the risk of a relapse of the depression. Never change your dosage without checking with your doctor first.
Since the medical response to SSRIs can vary among people, your doctor will consider the severity of your depression or disorder, as well as your response to the drug before switching to another medicine. When switching is appropriate, some options include:
This involves maintaining your current level of citalopram, while adding a second medicine to offset the sexual side effects. This option is generally less desirable since antidotes frequently have their own side effects and may adversely interact with the primary medicine you are taking. However, certain options do exist.
Sildenafil (Viagra) and related drugs may be helpful for men with sexual side effects of SSRIs. Bupropion also has been shown to benefit men with sexual dysfunction due to taking SSRIs. Amantadine has been used, but studies have not proven that it is beneficial.
This involves taking your usual Thursday morning dose and then nothing again until noon on Sunday, when you resume your previous schedule.
There is a risk with this technique that you may feel well enough during the short drug holiday to discontinue your medicine all together, which can lead to a relapse. Also there is a risk of having some withdrawal symptoms from abruptly stopping your medicine. Make sure you discuss this option with your doctor before trying it.
The efficacy of herbal supplements to treat the sexual side effects of SSRIs is not clear. Care should also be taken with herbal products because they are not strictly regulated as drugs are. One herb commonly used to resolve the sexual dysfunction associated with SSRIs is yohimbine. More studies are needed to determine the effectiveness and safety of this remedy. Be sure that you talk to your doctor before taking any herbs or supplements. They could react with medicines that you are currently taking.
Canadian Psychiatric Association
Sex Information and Education Council of Canada
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Last reviewed July 2012 by Brian Randall, 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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