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Thursday, Dec. 24, 2009

Antidepressants and Sexual Response

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A common side effect of many antidepressants in the SSRI (selective serotonin reuptake inhibitor) class is “sexual side effects” in both men and women. These include decreased libido and anorgasmia.  Are there any remedies that don’t interfere with SSRIs and birth control that can relieve these unpleasant side effects?

To answer this question, I consulted with a colleague of mine who is a psychiatrist in the Milwaukee area. She confirmed that any antidepressant that works on serotonin, such as Prozac, Celexa, Lexapro, Paxil, or Zoloft, can have sexual side effects. These side effects can include a loss of interest in sexual activity (some people might say "I just don't ever think of it" or "I really don't want to be touched") and/or a slowing of sexual response, e.g., taking longer to reach orgasm or not getting there at all. 

Within the group of antidepressants that work on serotonin, some studies show that Prozac may be a little less apt to cause sexual side effects, although each person's response to medication is individual, so this might not be true for everyone.  Sexual side effects are often dose related, so may not be there at lower doses; asking your doctor if it's possible for you to take a lower dose of your current medication may be helpful.

Wellbutrin is an antidepressant that does not work on serotonin at all, and thus, it tends NOT to cause sexual side effects. In fact, Wellbutrin has been the most effective thing added to medications that affect serotonin to counteract the sexual side effects. This doesn't work for everyone, and has side effects of its own, but appears to be the best solution so far. 

Other things that have been tried include Gingko Bilboa, an herbal extract, but not with consistent improvement. Herbal or natural supplements can interact with prescription or over-the-counter medications, so it's important to talk to your doctor before trying Gingko for this purpose.

Some of our customers at the Tool Shed who take antidepressants have reported that using clitoral stimulating gel has helped them reach orgasm. In fact, this is the main reason that we carry it -- I'm not a big fan of "stimulating gels" or "enhancers" in general, because I feel that they often make claims about their effects that can't be substantiated, but some of our female clientele who were taking antidepressants requested clitoral stimulating gels and said that they really worked for them. There's a new study underway right now that is examining the effects of stimulating creams on women, including women taking antidepressants, but it will probably be at least a year before the results of this study are published. If you're interested in participating in this study, more information about it can be found at https://www.indiana.edu/~whs/.

Laura Anne Stuart owns the Tool Shed, an erotic boutique on Milwaukee’s East Side. She has a master’s degree in public health and has worked as a sexuality educator for more than a decade. Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.