A while back, a reader asked me if I’d cover the topic of intimacy complications with regard to antidepressants.
Ah. Yeah. Every time I write about this controversial topic, I usually get hammered by the left, right, and center. This is obviously delicate ground, so let me tread lightly.
In a recent Johns Hopkins Health Alert called “The Challenge of Antidepressant Medication and Intimacy,” I read this:
While sexual dysfunction is a frequent symptom of depression itself (and successful treatment of depression may eliminate it), antidepressant medication can sometimes worsen or even cause sexual problems. In fact, sexual dysfunction is a potential side effect of all classes of antidepressants.
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Please address the subject of “Sexless Marriages” as a result of SSRI’s. PSSD (Post SSRI Sexual Dysfunction), although rare does occur, sometimes as a permanent effect. We thought we were alone in this issue. Many people have written to me, relieved that they are not alone. Most, unless the relationship is stressed already, learn to live with it. Afterall, if the feeling is gone, there’s nothing much to miss.
Lost in libido can also occur in relationship due to physical illness, low hormone levels and a number of other reasons besides a flaw in the relationship. As long as it is not a topic of contention or is not affecting the other partner – is this so bad?
My antidepressant (Effexor 160mg) makes it difficult for me to sustain an erection. If I can sustain it, then I have problems with ejaculation. It also has diminished my sex drive. Drug holidays don’t work well for me. If I miss a dose, then I will have bad dreams the night I skip. I take medicine first thing in morning. I like the idea of delaying taking it, but I have to plan ahead. Haven’t tried Viagra yet but sounds like another good idea.
Antidepressants obliterate your sex drive (SRI’s).
All the drug companies and psychiatrists as well, LIED about the incidence of these effects for years. As recent as 2003 or so the “official” number seemed to be 5% compared to over 70% now. It takes a lot of fraudulent research, dishonesty, and denial to keep such a pervasive effect under wraps.
And as someone who has taken almost every SRI drug at one time or another I can tell you that the quality of the way depression and SRI antidepressants interfere with “intimacy” is totally different.
SRI’s cause a much deeper and pervasive diminishment of the sex drive. They make ejaculation impossible.
If your depressed and transiently find yourself in a good space, your sex drive can return. Additionally your ability to ejaculate is not impaired.
Granted I am young, but the difference between the way a bad depression affects sexual function and the way antidepressants do is a totally different ballgame.
And with regard to the doctor who suggested patients go off their antidepressant for a “holiday” — good luck. She must still be in denial about antidepressants causing withdrawal.
For me, Depression and Anxiety is the real libido killer! All three antidepressants I’ve been on (2 SSRIs+Wellbutrin), actually INCREASED my sex drive. Wellbutrin increased it so much, that we joke and call it “My Viagra.” I think it’s actually prescribed for sexual dysfunction.
SSRIs helped a little bit, because I would have less anxiety about it. Just goes to show you that there are 2 sides to every story. Also, if you are severely depressed or anxious, how much sex drive can you really have? If you aren’t severely depressed or anxious, you probably won’t get much benefit from SSRIs and probably shouldn’t be taking them.
I think that one of the things that many people ‘forget’ (as Lynn said above), is that depression and anxiety themselves often interfere with the libido. I’d be interested to know what the rate of sexual dysfunction in depressed people is compared to the rate of sexual dysfunction after they go on meds.
I’ve had different experiences than most of the people that I’ve talked to with libido and different depression and anti-anxiety meds. Wellbutrin killed my libido completely, and most of the others (Prozac (the first time that I took it), Mirtazapine, Lexapro, Zoloft) raised it considerably. Meds affect individuals so differently that you really never know how you’re going to react until you do a trial.
I don’t think that I’d be anxious to try a drug holiday on certain meds- after going through horrendous withdrawal from both Lexapro and Zoloft, the brain zaps even after 24 hours would be enough to kill whatever sex drive I might gain from it.
Thank you for addressing this issue. While the suggestions given may work for some, depending on the medication, dosage, and duration of administration, as I pointed out, PSSD (Post SSRI Sexual Dysfunction) or permanent loss of sexual function can occur. There are many blogs out there of very angry men and women who fell victim to this without warning of this potentially damaging side effect.
Wellbutrin was recommended several years ago to my husband. The doctor failed to warn him that in some cases it has other unwelcome side effects. After three days in the hospital and $25,000 worth of test to learn what wasn’t wrong with him, it was determined it was causing seizures.
Viagra is fine if you can afford it. Insurance does not cover this product.
My husband ended up with this problem while on the lowest dosage for a short period of time, so in his case, cutting back would have meant quitting completely. This covers time of day and splitting up the dose, as it would not have made a difference. Cymbalta was the culprit in our case.
I must agree with the previous post about drug holidays. They can cause withdrawal effects and worsening symptoms which is counteractive.
I suffered for quite awhile from the same problem although I was on off label medication for depression. Fortunately, I have recovered, although not fully. Unfortunately, I too cannot come up with viable ways to avoid sexual dysfunction when anti-depressants are necessary. The way I see it if depression was contributing, you take the SSRI and you are no longer depressed. However, then you’ve lost your libido, and you’ve got something new to be depressed about. People should be warned in advance and so should their partners.
The best I can offer is lots of spicing things up, imagination and visual stimulation w/o engagement, let things build and hope for the best. Those sex classes may be a good idea.
I was put on three different anti-depressants (celexa, zoloft and wellbutrin) for anxiety and all of them had the ‘sexual side effects’ that are barely mentioned when the doctor give you the medications. The fourth (prozac) was the same way but I was sick of changing, so I decided it was time to try something else.
The way I figure it, there is good stress and bad stress. Sex takes a certain amount of good stress in order for there to be a buildup before the release (orgasm) at the end. For me it took spicing up the sex life quite a bit with toys and games, but then things worked again.
Probably isn’t for everyone, but if it helps someone then it was worth posting.
I’m a 28 year old female who started antidepressants after plunging into depression after my (second or third) stroke. I was 24. It sucked.
I could’ve kissed the guy who discovered Zoloft … until about two weeks after I started. After six months of no orgasms, I was done with the stuff. I called my doctor.
“Hello. I’m done taking Zoloft. The side effects suck.”
“Well, what would you like to take instead?”
“Wellbutrin.”
“OK. Good choice!” (I was surprised to hear her reaction … if she thought it was a good choice, why didn’t she START me on it?)
She told me to stay on a (relatively) low dose of Zoloft, which I did — 25 mg/day. The difference was significant, though I DID still feel the Zoloft.
One day, my social worker asked me about my sex life. Now, I don’t like discussing my sex life with anyone — *especially* not my male social worker — but it was an interesting conversation.
“Are you experiencing any side effects from the antidepressant medication you’re on?”
“Yes.” (Note my long, wordy responses.)
“I’m sorry. I know that decreased libido can be a drag, but there are several things you can –”
“Uh … that’s not the problem.”
“Oh? I’m sorry for assuming. What’s the problem?”
(Oh, crap. Now I’ve got to describe the problem. This sucks.) “My problem is, uh, finishing …”
“Oh. Well at least you don’t have a decreased libido!”
“Really? ‘Cause from my perspective it’s really not.”
“Yeah, I can see that. It’s as if there’s ONE thing you’re really good at, and suddenly it’s not fun anymore. That does suck.”
I’ve since been told by other therapists that it’s not unusual to have problems orgasming on Zoloft.
Interestingly, I’m now down to exclusively Wellbutrin and my problems have gone away. I’m also *very* glad I HAD these problems, because there’s another side effect of Wellbutrin — it wakes me up! Nothing (Adderall, Ritalin, Effexor) worked after my third stroke, but Wellbutrin does the trick. Now, if I could just remember to TAKE it every morning, I’d be golden!
i used antidepressants(prozac and paxil) from the time i was 15 to 21. i used to have libido before the drugs, but while using the antidepressants i lost it, and after a year of quitting the drugs it hasn’t come back. its very annoying not to feel any sex drive. i dont know if this will continue all my life. people say the sex drive returns after you quit the drugs, but it hasnt after a year, and i want to have my libido back.
Well, I LOVED Lexapro- made me horny and kept me awake during the day (I have a problem w/ daytime drowsiness), but, I didn’t have a partner then so I didn’t know that it was going to be difficult to climax. Then, in short order, someone special came into my life and the insurance company quit paying for Lexapro (trying to force customers to take cheaper meds)… Bad news, since then, I have tried several other meds and either unpleasant side effects or ineffective. In the meantime, I have hit menopause, so I am not sure what is the result of the antidepressant (was on Zoloft but it just quit working, and for now- until I go back to the psychiatrist- I am taking the samples she gave me of Pristiq- but it wires me up so bad I am in constant action and can’t hardly sleep at night) and what is the result of menopause. I am online doing research to come up w/ a regimen to try; I’m not giving up my sex life! Thanks for letting me share.
Jaelle — it’s not menopause. I’m not sure that menopause normally reduces libido, but I was very sexually active until 5 years ago (I’m now 68), high drive, multiple orgasms, would hve preferred having sex all day to doing anything else. Then I moved to a new town & haven’t figured out how to meet men here yet. I’ve been taking Effexor for several years, and I had noticed that I was having trouble going all the way to/through orgasms when masturbating. I’m now weaning off the Effexor (no withdrawal symptoms yet, but I’ve read that some people don’t have them till after they take that last little piece of a pill). There’s a forum (SSRIsex@yahoogroups.com) with many posts from people WHO NEVER GET THEIR SEXUALITY BACK. EVER. Even though I haven’t had anyone to have sex with for 5 years, that doesn’t mean I won’t someday. My best lover ever just contacted me. He has the same problem. We used to be the 9th Wonder of the World. Now — ?? We don’t know what’s going to happen.
EVERYONE: Don’t let them Rx you any more SSRI’s or SNRI’s unless you’re clinically, suicidally, chronically depressed.
Well I am not as experienced in sex as most of you. But I haven’t been able to achieve orgasms in a long time. It’s gotten to bad that I don’t even feel excited for sex. When my partner wants to have sex I kinda dread it… I am taking zoloft and now that I know that might be the reasons to my problems I am considering switching my medication. I just hope that I can go back to normal, but it confuses me because when we first met we were fine, and I already was on zoloft. I achieved orgasms just fine. Now though, its very hard for me and feels impossible.
I’m 22 years old. I started back on the Zoloft three years ago and I have a hard time having an orgasm. I masturbate and I don’t feel as aroused as much as I should be. I might try a sex toy or maybe zestra. I’m hoping wellbutrin will be the last thing I need. I have a hard time getting horny and that takes awhile.
I’ve been doing a bunch of research on effexor and other antidepressants, their side effects, and also the effects of withdrawal, and they are absolutely horrible! Both staying on it and getting off seem like hell. Having watched as my fiance has gone through some of these awful effects, I’ve been looking into options. I’m really no expert, but the most interesting and hopeful thing I’ve found is a website called point of return. It’s extremely informative and supportive and provides a safe and less traumatic way of getting off medecine that’s taking over your life. I just thought someone might want to check it out.
I’ve been on antidepressants since I was 14. I started with Celexa which gave me terrible stomach problems. I was switched to Lexpro shortly after that, and that’s when I first noticed the extreme “pain” during sex. I was so shocked when I first felt the pain because I had never had such complications before. I had always had a healthy normal sex life. The pain increased over time to the point that I was no longer able to have sex with out bleeding. It looked like a massacre in our bed. Then it increased to the point wear I couldn’t have sex without feeling the pain on entry!! The most enjoyable part…I would cry, sometimes even scream. My finance is a patient man, and he was willing to try anything to fix me. I went to obgyn’s after specialist. No one could figure it out. I was diagnosed with vaginitis at one point which was just a cop out for my obgyn because vaginitis is a muscle issue, and my problem had to do with the nerves. It got so bad I couldn’t even physically touch myself. I went to my towns local sex store and told them my issue. They recommended desensitation spray, which is a tropical spray that actually numbs the surface of my skin so I could have have sex without pain. The spray worked! So for months I had to use numbing spray, and thick lube to even engage in sex. The pain was still there…. but it was manageable. The numbing spray did make it impossible to climax. But at this point it wasn’t about me it was about saving my relationship. During my fight for my sex life I changed antidepressants because I wasn’t happy with lexpro. I
changed to zoloft. Within the first month I became a sex feign. All I wanted was sex. The pain is gone. Climaxing is still difficult, but I can actually enjoy sex now. No topical sprays, no lubes! Thanks Zoloft!
^^^MEN LISTEN to JC!!!^^^
My husband finally made a huge step (for him) to seek out a psychiatrist. He was prescribed Lexapro.
Our sex life has ALWAYS been fantastic! Not even TWO days later, he could not ejaculate, which happens every now and then… so, we tried the next day, all sorts of ways too.
No ejaculations.
This went on for SIX days STRAIGHT! He quit taking it. Tried THREE more days, now it was becoming a ‘task’, for both of us. I felt so bad for him!!
Finally, after TWO more days, still OFF of Lexapro and a lot of work at it…he ejaculated.
I wanted to celebrate like it was New Year’s!!
This type of thing can interfere with relationships and possible HEALTH concerns…
I have done extensive research on this matter and most TRUTHFUL websites including John Hopkins say ALL SSRIs WILL do this.
I understand people really need this sort of medication due to major depression. I just BEG you to seek an alternative if there is one that works for you…
I, myself, have been on different medication, lost count, over the past 8 years and SSRIs have giving ME complications EVERY time.
We are ALL different when it comes to side effects, this is MY ‘horror story’ and experience, not to mention research.
Use discretion and PLEASE listen to your body!
( Our ages: I’m 32 He’s 40.)
I felt VERY obligated to add this comment.
SSRIs are very nasty, in my opinion.
Those of you who are experiencing a GOOD reaction, you are very lucky and I am happy for you!
Sincerely,
Amanda
As the husband of someone who’s been on antidepressants for ten years, I have to say the whole situation is miserable. My wife can’t function without her meds, but there’s no magic, none whatsoever: no sense of possibility, no mystery and no hope to return not even to intensity but just to normalcy. I try not to be selfish about it, for I realize that the drugs allow her to make it through the day, but really there’s not a lot of bonding except for paying the bills and raising the kids.
I used to take antidepressants you name it i tried it. I finally woke up and realized there is no majic pill that will bring back the jobs to America and there is no pill that stops rising prices on goods due to the weak dollar. I do not take any drugs at all and i feel the same no better and no worse. The only benefit i had on antidepressants was that i could last like the Energizer bunny while on them and go for hours and still not climax sometimes. Not climaxing was the thing i didn’t care for and if your a single guy on this stuff and you happen to practice safer sex then you are almost guaranteed not to climax like me so the antidepressants made me choose to not practice safe sex. While on Welbutrin it made me grind my teeth during sleep and caused a lot of damage to my teeth. If a spouse does not want to be intimate that almost always suggests they are having an affair or they are on the verge of having one. Medication is hardly ever the blame for not wanting to be intimate it is an excuse most of the time. If you love your spouse then obviously you would want intimacy right? Personally i would give an ultimatum and let her know that if you have to that you will find it elsewhere and at least it is fair and honest and you are giving her the choice and if she does not show any intimacy still yet then she is giving you permission to find it somewhere else. A friend of mine went through this with his wife after a hysterectomy and she was using it as an excuse because she told me she was cheating on him and she asked me to sleep with her. They are still married but he has a friend with benefits on the side and so does she still yet and neither one know about the others affairs.
I am 30 years old have been taking Lexapro for approx 3 years. It was prescribed to me to help in my recovery from an eating disorder and the depression and anxiety that came with it. My libido has dropped to a definate 0 over this time. I feel much happier and calmer yet I have absolutley no interest in sex with my husband at all. This is tearing us apart. I try to have sex with him at least once a week, but it really does feel like one extra chore I have to do around the house. This saddens me greatly as I do love him very much. Over the past month I have slowly come off Lexapro and I think maybe I’m starting to feel a bit of libido returning (it’s hard to tell so far) yet I have been feeling really down and teary and am beginning to experience anxiety again. I’ve made the decision to go back on my meds. After reading this blog I am going to ask my doctor about Wellbutrin. I’m hoping this will be the answer to my problems.
Wellbutrin was terrific for my nonexistent sex drive, but it also lead to a total absence of appetite, leading to hospitalization. It also made my anxiety worse.
My boyfriend is on three antidepressants including Wellbutrin. He had been off his medications for about 2 months and I got used to him that way. He’s been taking them again for a month. He’s only been able to finish once in that time. It was first thing in the morning, which is the furthest amount of time between his doses. I have a very high sex drive and have been researching this problem to understand his point of view. He’s been great about making sure I get mine, but I still feel bad when he doesn’t and we had been hoping to conceive. Thank you for this article.
I actually believed I had forever lost any interest in sex whatsoever on Remeron and Zoloft. Then I saw my psychiatrist of 10 years (I’d been away for 3) – he admitted me through the ER when stopping the Remeron brought on a melancholic-type depression. He said, “This isn’t her.” I was put back on Effexor XR, and I have my life and my sex drive back. I had forgotten about actually ENJOYING sex, having it be anything but a chore….
I’m Keough’s pain in the ass, he’s sitting across the table from me LOL – I’d love to chat with a fellow woman in my neck of the woods about going through bipolar (i/ii? iii?) ….drop me a line or stop by my place
Best Wishes,
Jen