Depression is often accompanied by sexual dysfunction, such as decreased interest and impotence, but the cure for depression may cause even more problems in this area. What's more, most patients who are having sexual difficulties while taking antidepressants don't mention it to their doctors.
All of the most popular antidepressants can cause sexual difficulties in both men and women, particularly a group of drugs called selective serotonin uptake inhibitors (SSRIs). This includes fluvoxamine (Luvox), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Studies show that these drugs can cause delayed orgasm or ejaculation or inability to reach orgasm or ejaculate at all. They also may inhibit sexual or erection. One study estimates that more than 80 percent of patients taking these drugs suffer some form of sexual difficulty.
Scientists must be careful when studying this problem. First, they must separate problems caused by depression from those caused by antidepressant medication. Also, they need to ask patients about sexual side-effects, since many folks won't mention them on their own. Finally, they need to make sure that sexual difficulties aren't being caused by factors other than depression and antidepressants.
Researchers at the Robert Wood Johnson Medical School in New Jersey evaluated recent studies of sexual dysfunction among people taking SSRIs. Overall, it appears that more than half of patients taking these drugs experience sexual difficulty. The most common complaint is delay of orgasm or ejaculation, followed by inability to reach orgasm or ejaculate at all (anorgasmia). Most studies report that sexual difficulties get worse with higher doses of antidepressants.
So what can be done for patients suffering from these effects? One choice is to add another drug that will overcome them. A number of drugs have been reported to help, but no clinical studies have been done to affirm the effectiveness of these drugs.
Some clinical studies report success with changing to antidepressants that are not SSRIs. These include amineptine (used in France, Spain, and Italy), bupriopion (Wellbutrin), mirtazapine (Remeron), and nefazodone (Serzone). These drugs, however, may not be as effective as SSRIs in controlling depression, especially if the patient also has a concurrent obsessive-compulsive or anxiety disorder.
If you're taking antidepressants and have any kind of sexual difficulties, talk to your health-care provider. These problems may be caused by your medication, and if so, there are ways to improve your situation and quality-of-life significantly.