Sex and antidepressants

In my final article about the effects of mental illness and treatments on sexuality, I would like to discuss the effects that many antidepressant medications can have on sexual function.

Although advances in psychiatric treatments over the past couple of decades have led to amazing improvements in effectiveness and tolerability of medications, any systemic medicine will still have some side effects.

Unfortunately, many antidepressant medications – used in the treatment of mood and anxiety disorders – can cause sexual side effects. Most commonly, these side effects involve either inhibition of orgasm among women or delayed ejaculation in men.

Even though many depressed and anxious individuals likely experience impaired sexual function before beginning medication, sexual problems that are the result of medication will be distinctly different.

For example, women who could have orgasms before beginning medication, but lose their ability once medication is started can assume this is the result of the medication. Any changes in sexual function that seem to begin after medication use are likely occurring as a result of that medication.

Fortunately, there are a variety of ways of overcoming these side effects without ceasing psychiatric treatment. In most cases, you should not consider impaired sexual functioning an acceptable long term outcome of treatment – unless you have chosen not to be sexually active.

If you experience impaired sexual function as a result of antidepressant treatment, it is important to mention this to your doctor. If you don’t talk about it, your doctor will not be able to help you.

Sometimes adding a second medication such as bupropion or yohimbine will reverse sexual side effects. Other times, switching to a different antidepressant may be an effective option.

If your doctor does not offer any options or doesn’t seem interested, seek another opinion. You shouldn’t simply live with this reduction in quality of life without at least attempting some solutions.

These very same side effects can be useful in other situations. Premature ejaculation, for example, responds very well to these same antidepressants. Now instead of delayed ejaculation being a problem, it is a solution.

Dopaminergic drugs like bupropion can also sometimes enhance sexual functioning in those with low libido or with difficulty having an orgasm.

Newer antidepressants without sexual side effects are currently under development and will be the subject of ongoing clinical trials before they are available on the market.

Developing an effective alternative without these side effects is one of the main goals of new drug development in this area – since this would be a big improvement to current options.

At Okanagan Clinical Trials we currently have several ongoing studies in anxiety disorders and depression examining new medications. If you are newly diagnosed or are not satisfied with your current treatment, contact our office to learn if you may be eligible for one of these studies. You will receive a free, no obligation medical assessment and immediate access to a psychiatric specialist.

 

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