People who take antidepressants report side effects from their mediation. A large number of those people report sexual dysfunction. Therapists who treat men and women for depression know how to assess the different types of medications that are available and choose the right one for their patients. Diagnosing the mental health issue or issues a patient has is an integral part of finding the right prescription.
What to Expect in a Doctor Appointment
If you want to begin taking antidepressants, you should expect a few things to take place during your first appointment. A doctor will examine your current mood, frequency of sex, interest in sex, and create a baseline of sexual function before prescribing an antidepressant.
After a medicine is prescribed, regular visits with the prescribing doctor will take place to assess sexual function. During those visits, your doctor or psychiatrist will separate the underlying mental health issue with the medication’s side effects to determine if an adjustment to your prescription is necessary.
When you are in one of these appointments, don’t be embarrassed to talk about an increase or decrease in sexual interest. Some treatment facilities offer testing of your genes to determine which medication you will respond to better. Genetic testing and blood tests gauge levels and how your body will respond to medication.
When you call a treatment facility to schedule an appointment, ask if it offers genetic testing and labs. The benefits of these tests are not limited to learning how your body will react to a prescription. The tests will also detect genetic predispositions to alcohol or substance abuse, mental health disorders, and other findings that can assist you in treatment.
Women and Sexual Dysfunction
Women are at an increased risk for depression. In a study performed by the Mayo Clinic, the researchers found:
Relative to men, women are at increased risk for depression and anxiety, as well as increased risk of sexual dysfunction. Depression may impair sexual well-being by reducing motivation for or reward from engaging in pleasurable activities, interfering with intimate relationships, or increasing the risk of smoking or substance abuse.
The study also noted:
- Notably, as depression can itself impair sexual function, some women’s sexual function improves when taking antidepressants. For example, in a large clinical trial, depressed women who were untreated had a higher odds ratio of experiencing sexually related personal distress than depressed women who received antidepressants.
The study supports the belief that taking an antidepressant is beneficial and may increase your well-being.
Men and Sexual Dysfunction
Men who take antidepressants are not immune to the side effects associated with antidepressants. The most common side effect is erectile dysfunction. Men can also experience:
- A change in sexual desire
- Orgasm issues
- Problems with becoming aroused or sexually satisfied
The side effects of antidepressants are not uncommon, and you aren’t alone in experiencing some form of sexual dysfunction.
Types of Antidepressants
There are different types of antidepressants. Your doctor or psychiatrist will determine which type will work for you based on their assessment. Talk with your doctor about the side effects.
The Mayo Clinic reports these types of antidepressants are more likely to cause sexual dysfunction:
- Selective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), which include venlafaxine (Effexor XR), desvenlafaxine (Pristiq) and duloxetine (Cymbalta).
- Tricyclic and tetracyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor), and clomipramine (Anafranil).
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). However, selegiline (Emsam), an MAOI that you stick on your skin as a patch, has a low risk of sexual side effects.
The Mayo Clinic also reports these have fewer sexual side effects:
- Bupropion (Wellbutrin XL, Wellbutrin SR)
- Mirtazapine (Remeron)
- Vilazodone (Viibryd)
- Vortioxetine (Trintellix)
Your doctor or psychiatrist wants you to be successful in your treatment and work with you to find the right medication. Talk with your doctor or psychiatrist about the side effects of the medicine. If you are afraid, you might forget to ask questions, write your questions down before the appointment.
Ways to Increase Sexual Function
Taking a prescription for depression doesn’t mean your sex life is over. Talk with your doctor or psychiatrist about how you can retain a healthy and satisfying sex life. Be open to different ideas and suggestions. An article published by Harvard from their medical school reviews a few ways to boost your sex life:
- Lowering the dose. Sexual side effects may subside at a lower, although still therapeutic, dose.
- Scheduling sex. Your medication may produce more pronounced side effects at particular times of the day, for example, within a few hours of taking it. If so, you can try scheduling sexual activity when side effects are least bothersome—or take the drug at a different time.
- Taking a drug holiday. Depending on how long the drug usually remains in your body, you might stop taking it for a few days—for example, before a weekend, if that’s when you hope to have sex. Scheduling sex isn’t spontaneous, but it can work if you carefully follow your doctor’s directions about how to stop and resume your medication. However, there is always a chance that this might cause a relapse, especially if it is one of the drugs that leave your system relatively rapidly.
- Switching to a different drug. Certain antidepressants, such as bupropion (Wellbutrin), and mirtazapine (Remeron) are less likely to cause sexual problems. Bupropion, which affects both norepinephrine and dopamine, can sometimes improve sexual response.
- Adding a drug. For some men, taking sildenafil (Viagra) or tadalafil (Cialis) can alleviate SSRI-induced erectile dysfunction. For women, these drugs haven’t proven very helpful. However, men and women may both benefit from adding bupropion to their treatment. This medication has been found to counter SSRI-induced sexual dysfunction, boost sexual drive and arousal, and increase the intensity or duration of an orgasm. Another drug, buspirone (BuSpar), can restore the ability to have an orgasm and increase libido.
An antidepressant doesn’t mean the end of your sex life. Instead, taking an antidepressant can address a mental health disorder that is causing sexual dysfunction. Mental health disorders such as depression or anxiety can cause women and men to withdraw from intimate relationships furthering their depression or anxiety. Those with mental health issues may seek unhealthy alternatives such as alcohol or substances to help them feel better emotionally or sexually. Alcohol or substances are not the answer to mental health disorders or sexual dysfunction. Achieve Concierge understands the link between sexual dysfunction and depression or other mental health issues. We also know it is essential to understand how your genes can affect how sensitive your body will be to a prescription. Our doctors and psychiatrists provide genetic testing to assess your genetic predisposition to mental health issues and certain medications. Schedule an appointment to learn more. You can call us today at (858) 221-0344.