How to Reduce Sexual Side Effects From Antidepressants

Tips for Coping with the Sexual Side Effects of Antidepressants

man and women in the bedroom contemplating the sexual side effect of antidepressants
How can you reduce the sexual side effects of antidepressants?. Noel HendricksonCollection/Photographer's Choice RF/Getty Images

One of the great ironies of depression treatment is that while depression can rob you of your desire for sex, the drugs that treat it can be much worse, causing not only low libido, but also erectile dysfunction and difficulties with orgasm. The following are some tips that you may wish to discuss with your doctor that can help reduce sexual side effects and restore your sex life.

Reducing Sexual Side Effects of Antidepressants

There are many different ways to cope with the sexual side effects of antidepressants which can vary from the timing of taking your drug to switching to a different drug entirely.

Each of these methods to manage sexual dysfunction won't work for everyone, but it's likely that, with trial and error, you will find the one which not only restores your sex life, but allows you to take your antidepressant until your depression clears.

We are listing a few tried and true ways of coping with antidepressant induced sexual dysfunction, but these are certainly not the only ways. Talk to your doctor about your symptoms and goals, as one of these approaches may be more likely than another to work in your particular situation. In addition, your doctor may have suggestions not listed here but no less helpful.

1. Reduce Your Dose

Under the supervision of a physician, it may be possible to lower your dose enough to reduce sexual side effects while still obtaining depression relief. For example, it has been shown that for some people 5-10 mg of Prozac may be just as effective as the standard 20 mg dose, but with less sexual dysfunction.

2. Schedule Your Dose Right After Sexual Activity

With certain drugs, such as Zoloft (sertraline) and Anafranil (clomipramine), it may be possible to schedule your daily dose right after the time you would normally expect to engage in sexual activity, when the drug's level in your body would be at its lowest.

For example, if you normally have sex at night, schedule your daily dose near that time and take it just after sex.

3. Augment With a Drug That May Reduce Sexual Dysfunction

Case reports and small clinical studies have found the following to be potentially helpful in counteracting sexual dysfunction: Symmetrel (amantadine), Wellbutrin (bupropion), Buspar (buspirone), Periactin (cyproheptadine), dextroamphetamine, Cyclert (pemoline) and yohimbine. Your doctor may suggest taking the drug prior to sexual activity or may put you on a daily regimen.

4. Take a Drug That Treats Sexual Dysfunction

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

5. Take a "Drug Holiday"

With the drugs Zoloft (sertraline) and Paxil (paroxetine) it may be possible to schedule a two day drug holiday each week in order to restore sexual function without losing the efficacy of the antidepressant. A drug holiday tends not to work with drugs such as Prozac (fluoxetine) which have a long half life.

6. Switch to an Antidepressant With Fewer Sexual Side Effects

For some people, methods to reduce sexual side effects such as reducing the dose of an antidepressant simply don't work. If that is the case it may help to switch to one of the antidepressants which are less likely to cause sexual side effects. Serzone (nefazodone) and Wellbutrin (bupropion) have been found in studies to have fewer sexual side effects than selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), and others. If drugs such as Serzone or Wellbutrin have an adequate antidepressant effect for an individual person these may make a viable treatment alternative to reduce sexual side effects.

7. Behavioral Approaches to Sexual Dysfunction

In addition to the medication related approaches above, behavioral modifications while continuing an antidepressant may also help reduce sexual dysfunction. Both exercising before sex and vibratory stimulation are suggested as possible options. In addition, psychotherapy, acupuncture, or even nutritional supplement approaches have been tried.

What Works Best to Relieve Sexual Dysfunction from Antidepressants?

As noted, there are many approaches for dealing with sexual dysfunction related to antidepressants. In one review it was found that adding in Wellbutrin (bupropion) for women and Viagra (sildenafil) or Cialis (tadalafill) for men was most effective in reducing these side effects, but other approaches which do not include adding another medication may be preferable for others.

Bottom Line on Sexual Dysfunction Related to Antidepressants

While antidepressants have the potential to greatly improve depression and anxiety, sexual dysfunction is common with many if not most of these medications. There are a number of medication related options as well as behavioral approaches that can help to deal with these side effects. Every person is different, which can make it hard to know what approach will work best for any one person. Finding the approach that works best for you may include some trial and error, but in response to your efforts you may find that not only is your depression lifting, but your sexual side effects as well.

Don't give up if you don't find the answers right away. Sexuality is an important part of life, and we are learning that sex can even be a stress management technique!

Sources:

Lorenz, T., Rullo, J., and S. Faubion. Antidepressant-Induced Female Sexual Dysfunction. Mayo Clinic Proceedings. 2016. 91(9):1280-6.

Taylor, M., Rudkin, L., Bullemor-Day, P., Lubin, J., Chukwujekwu, C., and K. Hawton. Strategies for Managing Sexual Dysfunction Induced by Antidepressant Medication. Cochrane Database of Systematic Reviews. 2013. (5):CD003382.

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