Treating My Depression Means Less Sex? 
Sexual Side-Affects of Antidepressant Medication

Nicholas A. Natale, PhD
Don A. DuBose, MD

The effectiveness of antidepressants for individuals who struggle with depressive symptoms is well known.   Many have found relief for depression through the use of name brand medications such as Prozac, Zoloft, and Celexa.  Unhappily, many also discover the unpleasant side-effect of lower sexual desire and performance while taking these medications. 

 Does treating my depression mean less sex?  I thought the whole purpose of treating my depression meant that I could enjoy my life more? 

 These medications are part of a family of drugs known as SSRIs (selective serotonin reuptake inhibitors).  A common side-effect of SSRIs is induced sexual dysfunction that can occur at any point of treatment.  The dysfunction can include a decreased interest in sex (libido), decreased physical response (arousal), as well as delayed or blocked orgasms.  Recent studies have shown that about 60% of patients report some sort of sexual complaint to their general care physician or psychiatrist while on SSRIs.  

 How does SSRIs effect my sex? 

 It is hypothesized that SSRIs affect the sexual response system by raising levels of serotonin.  Serotonin, a neurotransmitter, appears to have a negative impact on the desire and arousal phases of the sexual response cycle which consists of four phases including: desire, arousal, orgasm, and resolution. 

 Can anything be done for about the sexual side-affects? 

 Here are some practical helps for reducing the impact of SSRIs. 

 1.      Talk to your doctor.  Do not hesitate to discuss the issue with your prescribing physician.  A person’s sex life is a significant part of their overall wellbeing.  Your doctor understands how important your sex life is to your health.  Discuss the issue with your doctor. 

2.      Work with a qualified sex therapist or relationship counselor to help discover new ways to explore sexual activities and arousal that takes the side-effects of the medication into consideration.  Contact Dr. Nic Natale to address issues of sexual desire, arousal, or performance related to your medication. 

3.      There are medication options for depression that are outside the SSRI family.  Bupropion (Wellbutrin) and nefazodone appear to be less likely to cause sexual dysfunction (approximately 10-25% of patients experience sexual dysfunction).  Mirtazapine (Remeron) also appears to be associated with a low rate of sexual side effects.

4.      Some studies show a significant improvement in sexual functioning by taking a brief “drug holiday,” or by simply lowering the dose of the antidepressant medication.  However, you should discuss this option with your doctor, as to minimize any potential relapse of depressive symptoms. 

5.      Some people may benefit from augmentation of their antidepressant medication with drugs such as sildenafil (better known as Viagra), which improves sexual arousal but does not necessarily improve the ability to achieve orgasm or increase desire.

6.      Explore alternatives to the traditional depression treatments such as TMS.  Transcranial Magnetic Stimulation (TMS) uses short pulses of a magnetic field to stimulate nerve cells in the area of the brain thought to control mood.  The pulsed magnetic field may have a positive effect on the brain’s neurotransmitter levels without the use of any medication.  This relatively new treatment for depression is demonstrating amazing results for patients who have not be able to receive relief through their medication regime or the side-effects of the medication has become a severe source of distress for them.  If you continue to experience adverse side-effects, contact Dr. Don DuBose for a TMS consultation. 

 Treating your depression does not mean that you must go without pleasurable sex.  If you believe you are experiencing sexual dysfunction due to your antidepressant, discuss it with your counselor, therapist, or prescribing physician.  

Take action.  Begin the conversation.  You don’t have to give-up sex to alleviate depression symptoms. 

 

Dr. Nic Natale, PhD is a psychotherapist and sex therapist at Palmetto Counseling Associates in Columbia, SC.  His focus on sexual health and relational issues is constantly informed by leading research, cultural trends, and a biblical perspective.  Dr. Natale can be reached at nicnatale.com.

Dr. Don DuBose, MD is a leading psychiatrist in the field of depression and the medical director of Future Psych Solutions in Columbia, SC.  His introduction of TMS to the midlands have revolutionized treatment for depression.  Dr. DuBose can be reached at
futurepsychsolutions.com.