December
2007
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December
2007
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| Of Like Minds is now Mood! Over 175 articles on: Help support Mood --
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You’ve lost that lovin’ feeling... |
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We’re depressed or anxious and we don’t feel like doing anything. Especially making love. So, we take antidepressants or other psych meds and we feel a lot better. But, because of the drugs, now we not only don’t feel like making love, it’s become a challenge to have a satisfying experience. Can anything be done about it? For some people, antidepressants and other drugs for depression, bipolar or anxiety disorders improve their mood and their sex lives. Others have trouble getting in the mood (loss of libido), have trouble performing (erectile dysfunction, or ED) or “can’t get no satisfaction” (anorgasmia, or difficulty in achieving orgasm} No one really knows the statistics of sexual problems resulting from psych meds because patients don’t often talk to their doctors about it. So, although the product labeling on your drug may say its incidence is 0 to 14 percent, that’s probably underestimated. Some researchers would put it closer to 70 percent for some antidepressants. What drugs can cause sexual problems? Antidepressants
The incidence of SD varies widely among other classes of antidepressants. Effexor, an MAOI (monoamine oxidase inhibitor) has been shown to cause more sexual side effects than many other antidepressants. Wellbutrin, on the other hand, typically does not cause them, and in fact can help reduce symptoms caused by other drugs. The tricyclic antidepressant Clomipramine (Anafranil) has been shown to have the greatest potential to cause delayed ejaculation. And, in one study, 70 to 96 percent of men and women taking this medication had trouble reaching orgasm or were unable to reach orgasm. Some men taking tricyclic antidepressants experience a loss of interest in sex or difficulty in maintaining an erection. Mood stabilizers Antipsychotics What can reduce sexual side effects? Little research has been done on finding remedies for the sexual side effects of psychotropic medications. (Obviously, there aren’t enough researchers living with the problem.) Most doctors approach the problem by relying on “clinical wisdom, anecdotal reports, case reports, and open-label studies,” according to one report. Possible options include decreasing the dosage, taking drug holidays, adding another medication, switching to an alternative medication without these effects, or waiting for tolerance to develop. And, just as important…romance. Waiting it out Adjusting dosage Drug holiday
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“In general, in my view at least, and I know mine is widely shared, the very idea of any "drug holiday" is a terrible idea, says Jim Phelps, MD. “Mood stability is the goal, not the treatment of any particular episode. Rather, we want to prevent the next one.” A drug holiday would work only for medications that maintain a therapeutic level for a few days, preventing the risk of relapse. Some drugs, such as fluoxetine (Prozac) can’t be eliminated from the body fast enough to reduce sexual side effects. NEVER take a drug holiday without thorough discussion with your doctor. The two most effective management options are adding another drug and switching to an alternative. Switching medications A risk of switching is that the new drug may not be as effective as the original. Adding another medication The following drugs given in specific doses in combination with other psychotropics (especially antidepressants) have been found to reduce some sexual side effects for some patients.
Adding romance Related articles Sources |
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An SSRI (selective serotonin reuptake inhibitor) or SRI (non-selective serotonin reuptake inhibitor) antidepressant is often a culprit. Ninety percent of Americans taking antidepressants are taking one of these. Forty to seventy percent of those report treatment-related sexual dysfunction (SD). Reduced sexual desire is common, and studies have shown that at least 30-60 percent of men and women will experience some delay or difficulty in achieving orgasm during therapy with an SSRI. Men often experience erectile dysfunction and delayed ejaculation. The five SSRIs marketed in the United States are fluoxetine (Prozac), 
Many doctors warn against this idea. People with severe depression should not take drug holidays, says Dr. Dana Simpler, Mercy Medical Center, Baltimore, MD. And, it can be particularly dangerous for people with bipolar disorder.