Got the Bedroom Blues Thanks to Your Antidepressant?

Wellbutrin May Be the Answer to Your Sexual Side Effects

Bottles of antidepressant pills. Joe Raedle / GettyImages

You've no doubt heard that antidepressants can cause a whole host of negative sexual side effects, which is rather ironic considering that depression itself often steals your sexual desire in the first place.

Antidepressants and Sexual Side Effects 

Sexual side effects can include erectile dysfunction, lack of desire, difficulty with arousal and difficulty or inability to orgasm, The drug classes known as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are associated with a higher rate of sexual dysfunction.

These include common medications such as Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Effexor (venlafaxine), Pristiq (desvenlafaxine) and Cymbalta (duloxetine).

Three antidepressants are associated with lower rates of sexual side effects, including Wellbutrin (bupropion), Remeron (mirtazapine) and Viibryd (vilazodone). Studies suggest that sexual dysfunction may be related to antidepressants that target serotonin levels, like the SSRIs and SNRIs do.

What To Do If You Are Having Sexual Side Effects From Antidepressants

If you are having sexual side effects from your antidepressant, be sure to tell your mental health professional, who will work with you to figure out how to minimize these side effects. Your doctor may try one of the following:

  • Seeing if you build up a tolerance to your antidepressant. Especially if you just started taking it, your doctor may wait a bit before trying something new. Sometimes unpleasant side effects go away with time.
  • Lowering your dose so that side effects are not so troublesome. While this may help your sexual side effects, it may worsen your depression, so be prepared to try something else in case this doesn't work.
  • Having you take your antidepressant after your engage in sexual activity. 
  • Adding another antidepressant to your current one. Studies have shown that sexual side effects may be reduced when Wellbutrin is added to your treatment plan.
  • Starting you on a medication specifically to address your sexual issues. Your doctor may decide to put you on a medication such as Viagra (sildenafil), Cialis (tadalafil) or Levitra (vardenafil). 

Who Should Not Take Wellbutrin

Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI). It is contraindicated in patients with a seizure disorder or those taking Zyban to stop smoking, which also contains bupropion. It is also shouldn't be used if you have a diagnosis of an eating disorder, such as bulimia or anorexia, and for those currently taking an MAOI or who have discontinued the MAOI within the past two weeks.

If you have just abruptly stopped alcohol, antiepileptic medication, barbiturates or benzodiazepines, you also should not take Wellbutrin. Be sure to tell your doctor about all medications, supplements and vitamins that you are taking, as well as about any other illnesses you may have.

Do Not Discontinue Your Antidepressant Without Your Doctor's Approval

Sexual and other bothersome side effects can be so intolerable, you just want to ditch your antidepressant.

Resist the temptation to do this without talking to your mental health professional first. It's risky to just quit taking your antidepressant without tapering off gradually. One potential problem is discontinuation syndrome, which can make you feel ill. You also run the risk of your depression returning. If you have stopped seeing your doctor, this can be especially dangerous.

If your side effects are intolerable, be sure to let your doctor know and together you can come up with a solution that will balance your depression with the fewest side effects possible. It just may take a little patience and experimentation with different medications for awhile.

Sources:

Hall-Flavin, D.K. "I’m worried about the sexual side effects from antidepressants. What can be done to prevent or reduce such side effects?" Mayo Clinic (2014).

Zisook S., Rush A.J., Haight B.R., Clines D.C., Rockett C.B."Use of bupropion in combination with serotonin reuptake inhibitors. " Biological Psychiatry 59 (3), 2006.

"BUPROPION- bupropion hydrochloride tablet, extended release." DailyMed, U.S. National Library of Medicine (2016).

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