Sex and Antidepressants

What Is Depression?

Major Depressive Disorder (MDD) is a mood disorder affecting approximately 6.7% of adults.  Depression symptoms vary from person to person but commonly include feelings of sadness or tearfulness, loss of interest in activities that were previously pleasurable, change in weight and appetite, change in sleep patterns, difficulty concentrating, feelings of excessive guilt or shame, or thoughts or plans of death/suicide. While many people have experienced some or all of these emotions during a grieving period in their life (such as the death of a loved one, divorce, or a job termination) it is important to distinguish that depression is a disorder, whereas grief is the result of a traumatic life event.  Depression is commonly treated via psychotherapy, medication, or a combination of both.1

Causes

Depression can emerge from several different factors, including one’s own biochemistry, genetics, personality, and environment. Specific levels of certain chemicals in the brain (called neurotransmitters) have been identified by scientists as a potential cause for depression.1 Scientists have pinpointed specific genes that can be inherited from one’s parents and cause fluctuations in brain chemistry. The transfer of depression genes from parent to child makes MDD an inheritable disorder.2 Additional factors that influence the susceptibility to MDD include personality traits, such as having a negative self-image or a pessimistic attitude. Lastly, one’s environment (their potential exposure to loss, violence, neglect, or abuse) may make them more prone to depression.1

Symptoms

Symptoms of depression can include feelings of persistent sadness, irritability, emptiness, hopelessness, helplessness, guilt, worthlessness, and/or restlessness. People may also experience a loss of interest in hobbies or activities that they once found joyful, including sex. They may also experience body pains, headaches, and cramps along with fatigue and decreased energy associated with insomnia or oversleeping.3 Major Depressive Disorder can be life threatening, as severe symptoms can include thoughts of suicide or suicide attempts.1 Sexual dysfunction is also a common symptom of depression and can even be aggravated by antidepressant drugs.4

Antidepressants and Sex

Between 30 to 70% of people who take antidepressant drugs experience some sexual problems. Sexual side effects most commonly occur in the class of antidepressants called the selective serotonin reuptake inhibitors (SSRIs).5 These drugs include Cymbalta, Lexapro, Zoloft, Prozac, Celexa, Paxil, and others SSRIs.6  Overall, these antidepressants may cause both genders to experience a lowered sex drive or a difficulty achieving orgasm.Additionally, each gender may experience unique side effects, including vaginal dryness and lowered sensitivity in females, and erectile dysfunction in males. Keep in mind that not all people taking these specific antidepressants experience sexual side effects. There are some antidepressants (including Remeron and Wellbutrin) that are known to cause fewer sexual side effects. A person may want to consult their doctor about these medications if they are experiencing negative side effects from other antidepressants.6

 

Treatment of Antidepressant-Caused Sexual Dysfunction

Sexual dysfunction is a sensitive topic for most people and should be addressed with care. Treatment for sexual dysfunction caused by antidepressants should never be started without first consulting a doctor, as the risks associated with self-treatment outweigh any possible benefits. Some psychologists recommend their own patients to wait for the body to develop a tolerance to the drug (which may reduce the sexual dysfunction symptoms) or alter the time at which they take their medication by waiting until intercourse is finished

If these strategies are ineffective, one should consult their doctor about their sexual dysfunction and the possibility of changing medication. Some physicians recommend the following changes if sexual dysfunction persists:

    •    Take a “drug holiday” (i.e. a one to two day break from your medication). This should be done only after consulting a doctor due to the risks involved in stopping medication prematurely. According to research, taking a two day break from antidepressant oral medication can reduce sexual side effects without increasing depressive symptoms.7

    •    Consult a doctor to see if a reduced dosage may be possible; it may lessen the side effects.

    •    Consult a doctor about the possibility of incorporating Viagra, which has been shown to help both males and females improve the quality of their sexual encounters. One study tested the effects of Viagra verses a placebo on a sample of females taking antidepressants and found that the Viagra group had higher improvements in orgasm and sexual pleasure than the placebo group.8

    •    Consult a doctor about changing to a different antidepressant with lower reported rates of sexual side effects.7

    •    Speak with a doctor about the possibility of stopping medication completely if a patient believes that it will improve both their daily life and their sex life. This option has certain risks and should be done only under the close watch of a doctor and/or psychiatrist.

Concluding Remarks

When taking an antidepressant that leads to unwanted side effects, it is vital to consult a doctor or psychiatrist about which option is best. Stopping a psychiatric medication without tapering off first can be detrimental to one’s mental health and may cause worsening depression. With the help of a medical professional, a person may change their medication dosage, try a new one, or stop the medication completely, in order to regain the sexual function they desire.6

References

1. Parekh, Ranna. "What Is Depression?" What Is Depression? American Psychiatric Association, Jan. 2017. Web. 21 Jan. 2017.

2. Fabbri, C., A. Marsano, and A. Serreti. "Genetics of Serotonin Receptors and Depression: State of the Art." National Center for Biotechnology Information. U.S. National Library of Medicine, 1 May 2013. Web. 21 Jan. 2017. 

3. "Depression." National Institute of Mental Health. National Institute of Health. Web. 22 Apr. 2015. 

4. Borchard, Therese. "Sex on Antidepressants." This Emotional Life. PBS, 1 Jan. 2011. Web. 22 Apr. 2015. 

5. Rosen, RC. "Effects of SSRIs on Sexual Function: A Critical Review." Journal of Clinical Psychopharmacology. U.S. National Library of Medicine, n.d. Web. 23 Jan. 2017. 

6. Cherney, Kristeen. "Managing Antidepressant Sexual Side Effects." Healthline. 14 Mar. 2014. Web. 22 Apr. 2015. 7. Baldwin, David, and Andrew Mayers. "Sexual Side-effects of Antidepressant and Antipsychotic Drugs." BJPsych Advances. The Royal College of Psychiatrists, 1 May 2003. Web. 22 Apr. 2015

8. Stulberg, Debra, and Bernard Ewigman. "Antidepressants Causing Sexual Problems? Give Her Viagra." The Journal of Family Practice. Quadrant HealthCom Inc., Dec. 2008. Web. 23 Jan. 2017. 

Last Updated: 7 February 2017.

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