Antidepressants’ sexual side effects can impact patients’ quality of life, decrease self-esteem, affect relationships, and even force patients to stop the medication. That’s why people need to know it is normal and expected that they discuss sexual issues with a doctor before and after starting an antidepressant.
Learn About How Antidepressants Affect Sex Drive:
Side Effects In Men
Studies show that men experience slightly more sexual side effects than women, and that 40% of people who are under treatment with antidepressants will develop a form of sexual dysfunction at some point. Erectile dysfunction from antidepressants is actually the most common reason for discontinuing antidepressants. Other related symptoms are decreased interest in sex or the inability to reach an orgasm.
Other side effects include:
- troubles with getting or maintaining an erection
- painful erection
- painful or delayed ejaculation
Also, some drugs, such as Celexa, might lower the sperm count.
Side Effects In Women
Antidepressants can affect women in many of the same ways, with decreased libido or ability to achieve an orgasm. Other common sexual side effects in women include:
- lactation that is not caused by breastfeeding or pregnancy
- numbness in the nipples and vagina
- discomfort during sex
Women under serotonergic antidepressants treatment might experience blocked or delayed orgasm, delayed lubrication, or lack of interest in sex.
Some antidepressants can also disrupt the menstrual cycle causing irregularities or changes in this process. Bupropion, Venlafaxine, and Fluoxetine can rarely cause menorrhagia (prolonged or heavy menstrual bleeding), while Bupropion might also cause menstrual spotting, shortened menstrual cycle, or the absence of menstruation.
Managing The Sexual Side Effects Of Antidepressants
From 700 patients that took part in a survey, 38% said they had experienced a reduced sex drive. But sex on antidepressants can be normal and enjoyable, and sexual dysfunction doesn’t have to be a permanent side effect.
There are various methods on how to increase libido while on antidepressants if the patient does not experience any improvement after a few months since the beginning of the treatment.
If the side effects do not wear off in a few months since the beginning of the treatment, patients should feel comfortable asking their doctor to prescribe other medication, as different antidepressants have different side effects.
Lowering A Dosage
There is also the possibility of decreasing the current dosage if the patient feels the medication is effective but with bothersome side effects. The patient will be put on lower doses, and the progress will be monitored to decide which is the lowest dose the patient can take but still be effective.
Add a New Drug
Another solution to diminish the antidepressants sex drive side effects would be to add a drug that targets sexual dysfunction, such as Cialis, Wellbutrin, or Viagra. These drugs counter the sexual dysfunction induced by SSRIs and boost sexual response in both men and women.
It is not recommended to switch medication, adjust a dose, or take additional drugs without medical supervision. Any of these actions may lead to unwanted health hazards. Patients should always consult with a doctor first and contact a rehabilitation facility if signs of dependence or abuse are noticed.
For some patients, a sex therapist or a mental health professional can be helpful. Through therapy, patients can:
- explore their sexual issues and concerns
- find a bridge between antidepressants and relationships with their intimate partners
- learn how to communicate their sexual needs
- expand their sexual connection and sexual activities
Although it might take some time to find the right mix between psychotherapy and medication, this can help patients remain on an antidepressant and maintain a satisfying sex life.
There are some personal changes that patients can do to work through antidepressants’ reduction of sex drive:
- Foreplay. It takes an essential place in stimulating the mind and body and promote natural arousal. Allowing the body to go through the natural process that usually makes the person feel sexual arousal is important.
- Have sex before taking that day’s dose of medication.
- Reduce stress levels, get exercise, and get plenty of rest. Those can all boost levels of dopamine and sex drive.
Antidepressants Without Sexual Side Effects
For those who find that their current antidepressants negatively influence their sex life, there are better drug options with few or no sexual side effects.
Atypical antidepressants are other options to consider for patients with major depression who experience intolerable side effects from SSRIs. Atypical antidepressants for major depression, such as Agomelatine, Bupropion, or Mirtazapine, are safe options for those who want to address sexual side effects of their current medication.
Tricyclic antidepressants (TCAs)
TCAs are one of the options to replace SSRIs. One of the most common tricyclic antidepressants is amitriptyline. The rate of amitriptyline-associated sexual dysfunction is lower compared to that of most other antidepressants.
Unfortunately, the sexual side effects of antidepressants are a reality that can severely affect patients’ quality of life. Some people experience sexual side effects and abruptly stop the medication, causing withdrawal symptoms and discontinuation of treatment. If depression goes untreated, risk of substance abuse is increased, leading some people to require specialized addiction centers and rehabs for substance treatment.
The best thing to do is remember that side effects from antidepressants are common and normal, so be comfortable talking about any concerns with your doctor. They can prescribe an adequate treatment plan aimed at avoiding these unpleasant side effects.
- Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug, Healthcare and Patient Safety. 2010; 2: 141–150. doi:10.2147/DHPS.S7634. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
- Chen LW, Chen MY, Lian ZP, et al. Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice. American Journal of Men's Health. 2018; 12(2): 370–379. doi:10.1177/1557988317734519. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818113/.
- Cascade E, Kalali AH, Kennedy SH. Real-World Data on SSRI Antidepressant Side Effects. Psychiatry (Edgmont). 2009; 6(2): 16–18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719451/.