Sexual side effects of antidepresssants

Sexuality is an important aspect of who we humans are. It is important on a personal and emotional level and in our relationships and connections to our significant others. Depression quite often takes away one's ability to enjoy just about anything, including sex. Unfortunately, medications that treat depression all too often also squelch sex drive and the ability to orgasm. When depression improves and the desire to resume normal life activities comes back, the desire for sexual relations often does not. Most of the newer antidepressant medications work by focusing in on increasing the brain chemical serotonin and it appears that when this neurotransmitter is increased and there is too great of an imbalance between serotonin and another neurotransmitter, dopamine. That's when you get sex drive and orgasm problems.

Though an ideal option is switching to a medication that is as effective and has less side effects, often a particular anti-depressant's effect may be better than all others tried, however and the option to switch medications is not viable. Addition of a medication that may increase Dopamine may need to be considered in order to offset the imbalance and correct the problem. The following are options to consider:

Ginko biloba- natural option
Wellbutrin
Stimulant medications
Buspar
Amantadine
Viagra- this option has been helpful for women as well, works best for anorgasmia rather than lack of libido

There are probably other options I am leaving out but this is a good start. Don't be shy to bring up any concern you may have with your doctor.

Paxil: a mixed blessing

Paxil and I have a love-hate relationship. First of all, when Paxil came out on the market it was welcomed because it is always great to have another choice of medications for our patients' well-being. It has been an excellent medication. It is very effective and sometimes nothing is as effective. Later, however, the luster began to fade and it's shine became duller. Though my patients found it quite effective, many came with embarrassment to tell me they no longer had a libido, or that they could no longer orgasm, or a one gentleman so horridly described it: "you could put a nail through it and i wouldn't feel it". Sexuality is such an important part of who we are as human beings and often so vital in our relationships that after such a good response to depression we needed to seek a cure from the side effect. We've tried numerous medications to counteract the adverse reaction but with limited avail. :(

Another problem was it's short half-life which means it is eliminated rather quickly from the bloodstream. This created severe withdrawl symptom. Not dangerous, mind you, but aweful. If nothing is done, it may last 1-2 weeks! That's a long time to feel miserable. Slow taper downward is very important.

Weight gain also happened in a few here and there.

To me it was a sad ending to a great start...but it can, for some, be just the right medication. One man's ceiling can be another man's floor.