Q: I'm taking an antidepressant. It is starting to affect my sexual performance. Is there something I can use or take to help with the sexual side effects?
A: Antidepressants have been a major advance in treating depression, but like all medications, they can have side effects. Sexual problems are particularly common with the popular and effective class of drugs known as selective serotonin reuptake inhibitors (SSRIs).
SSRIs can reduce sex drive (libido) and delay an orgasm or keep someone from reaching an orgasm. Delayed orgasm is so common that SSRIs are sometimes prescribed for men troubled by premature ejaculation. All in all, more than a third of the people who take SSRIs experience sexual problems. These vary in severity and can come and go during treatment.
Although some men report a benefit from taking Viagra, there is no really effective antidote for the sexual side effects of SSRIs in men or women. So what can you do? Here are three possibilities: First, talk with your doctor about reducing the dose of your medication—lower doses produce fewer side effects. Second, ask about taking a 1-day medication holiday when you anticipate sexual activity. Third, ask about switching to another antidepressant (such as bupropion) that might not have the same side effect.
You'll note that all of these options start by talking with your doctor. Depression can be serious, and you should not change your medication schedule without your doctor's advice. And while you're at it, ask how long you can expect to be on your antidepressant—if it's not too long, you might just decide to wait it out.
Sexual side effects of antidepressants are bothersome, even depressing—but they're not as bad as untreated depression.
