Sex and Antidepressants
What do you do if your antidepressant is interfering with your sex life? A psychologist specializing in relationships addresses this issue.
A reader is concerned because she can’t have an orgasm since taking an antidepressant, and wants to know what she can do. Another reader has lost all interest in sex since taking an antidepressant.
These concerns are very common. In fact, the number one reason for not taking many medicines as prescribed is because of the sexual side effects caused by the drug. Antidepressants aren’t the only medicines that can have sexual side effects, so it’s a good idea to always ask your doctor about possible side effects when you’re prescribed a new medicine.
The Chemistry Behind Pleasure
First, here’s some background on the connection between antidepressants and sexual experience. Antidepressants help relieve depression because they change the levels of the chemical messengers in your brain. These chemicals are called neurotransmitters and they help nerve cells talk to each other. Three neurotransmitters—serotonin, norepinephrine and dopamine—play a role in both mood and sexual pleasure.
Dopamine and norepinephrine are important neurotransmitters for experiencing pleasure and becoming sexually aroused. Serotonin appears to decrease sensation. It also indirectly affects how much blood flows to the genitals. Blood flow to the genitals is one of the main physical changes that happens when you are sexually stimulated—so it’s very important for an enjoyable sexual experience. The more a medicine decreases dopamine (pleasure) and norepinephrine (arousal), and increases serotonin (lower sensation and lower blood flow), the more likely the medicine will cause sexual side effects. The most common sexual side effects are trouble having an orgasm and having less sexual desire.
What You Can Do
If you are taking an antidepressant that causes sexual side effects, these strategies have helped others:
- If you’re new at taking an antidepressant, wait several weeks to see if the sexual side effects get better.
- Different antidepressants affect different neurotransmitters or affect them in different ways. Some antidepressants have lower risk of sexual side effects. If you’ve given your body time to adjust to your medicine and you’re still having sexual side effects, talk to your doctor about trying a different antidepressant.
- Talk with your doctor to see if it’s possible to adjust the dose you’re taking so you still get the benefits of the antidepressant, but with fewer sexual side effects.
- If your antidepressant is a once-a-day dose, have sex before you take it.
- Ask your doctor about adding a second anti-depressant or another type of medicine to counter the sexual side effects. For example, the addition of the antidepressant bupropion or the anti-anxiety medicine buspirone may ease sexual side effects caused by an antidepressant.
- If you are a man, ask your doctor about adding a medicine to directly improve sexual function, such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra). Some research has shown that these medicines may also help women who have sexual side effects from an antidepressant. However, this is early research, and these medicines have not yet been approved to treat women.
- Talk with your doctor about taking a two-day drug holiday each week.