How to Reduce Sexual Side Effects From Antidepressants

Coping When Your Libido Takes a Hit

man and women in the bedroom contemplating the sexual side effect of antidepressants
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An unfortunate irony of depression treatment is that while depression can rob you of your desire for sex, some drugs commonly used to treat it can be just as bad, if not worse. Sexual side effects of antidepressants include low libido, erectile dysfunction, and difficulties with orgasm. If you're taking an antidepressant and finding it's sapping the pleasure from your sex life, it's worth making an effort to turn that around—if not for your relationship then just for you: Sexuality is an important part of healthy living.

Reducing Sexual Side Effects of Antidepressants

Not all of these approaches will work for everyone, so it will likely take some trial-and-error to get your romantic life back to normal. Do talk to your doctor, though, because some of these tactics require fiddling with your prescription or adding an additional medication, neither of which you can do on your own.

1. Take a Lower Dose

With your doctor's guidance, it may be possible to lower the dose of your antidepressant enough to reduce the sexual side effects while still easing your depression symptoms. For example, it's been shown that some people get just as much relief from 5 or 10 milligrams (mg) of Prozac (fluoxetine) as from 20 mg, but with fewer sexual side effects.

2. Pop Your Pill After Sex

Scheduling the timing of when you take certain drugs, such as Zoloft (sertraline) and Anafranil (clomipramine) for right after the time you typically have sex may be one strategy to help lower side effects. That way you're engaging in intimacy at a time when the levels of the drug are lowest in your body. In other words, if you and your partner tend to make love in the evenings, get into the habit of taking your antidepressant at night.

3. Augment With a Drug That May Reduce Sexual Dysfunction

The antidepressant Wellbutrin (bupropion) is a norepinephrine-dopamine reuptake inhibitor (NDRI). It works somewhat differently than selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, and Paxil (paroxetine), and tends to not affect sexual dysfunction as much. Some people are able to switch to Wellbutrin alone and still get enough relief from their depression symptoms. Others can take Wellbutrin in addition to their regular medication. Ask your doctor if either approach might be an option for you.

4. Take a Drug That Treats Sexual Dysfunction

Drugs targeted at erectile dysfunction, such as Viagra (sildenafil) or Cialis (tadalafil), may help some patients.

5. Take a "Drug Holiday"

If you take Zoloft (sertraline) or Paxil you may be able to schedule a two-day drug holiday each week in order to restore sexual function without losing the benefits of the antidepressant. This strategy isn't likely to work with medications that have a long half life, such as Prozac.

6. Experiment With Alternatives

Both exercising before sex and vibratory stimulation are suggested as possible options. In addition, psychotherapy, acupuncture, or even nutritional supplement approaches have been tried. Don't give up if you don't find the answers right away.

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Article Sources

  1. Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug Healthc Patient Saf. 2010;2:141-50.

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