Sexual side effects and one’s libido are an important issue when it comes to antidepressant medications and depression itself. All too often, this issue is ignored when antidepressants are prescribed by a family physician or general practitioner. Yet sexual side effects are important enough that they should be addressed.
Although the focus of most depression treatment is on the alleviation of symptoms commonly associated with depression, some people are more sensitive to sexual side effects than others in certain types of antidepressant medications. For some people, their sex life may also be just as important as alleviating the symptoms of depression.
Research on Sexual Side Effects and Antidepressants
A 2001 study out of the University of Virginia examining the prevalence of sexual dysfunction among antidepressant users reveals that while the drug classes known as selective serotonin reuptake inhibitors (SSRIs, such as Paxil or Zoloft) and serotonin and norepinephrine reuptake inhibitors (SNRIs, such as Effexor and Cymbalta) were associated with a higher rate of sexual dysfunction, other antidepressants were associated with significantly lower rates, namely bupropion (Wellbutrin) and nefazodone (Serzone). These data suggest that sexual dysfunction may be related to serotonergic antidepressant therapy.
Wellbutrin, the brand name of bupropion, had the lowest overall rate of sexual dysfunction. It was associated with a rate of 22% of the overall population. The sustained release formulation fared almost as well with a rate of 25%. In contrast, the SSRIs (Prozac, Paxil, Zoloft and Celexa), venlafaxine (Effexor) and mirtazapine (Remeron) averaged about 40%. When subjects were removed who had other probable causes of sexual dysfunction, the results were even better. Wellbutrin’s rate dropped to 7% with the other medications dropping to between 23-30%.
Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI). It is contraindicated in patients with a seizure disorder or those taking Zyban, which also contains bupropion. It is also contraindicated for those with a diagnosis of an eating disorder such as bulimia or anorexia and for those currently taking an MAOI.
Results were presented on May 8, 2001 at the American Psychiatric Association annual meeting.
What This Means
People who are sensitive to sexual side effects should ask their doctor about switching to an antidepressant such as Wellbutrin or Serzone, which have lower sexual side-effect profiles than other commonly prescribe antidepressants.