Antidepressants and sexual dysfunction
Depression manifests as an overriding sadness about life. So it’s little wonder, therefore, that sexual dysfunction is more likely to occur in depressed people, and their antidepressant medication doesn’t always help.
© Thinkstock
Sexual dysfunction is among the most critical of the many issues caused by depression. It has long been regarded as a symptom of depression but it is now an established fact that sexual problems can also be one of the side effects of antidepressants. Read on to learn more...
When depression rhymes with sexual dysfunction
Whether it’s a lack of desire, erectile dysfunction and ejaculation disorders for men, or arousal and orgasm difficulties for women, studies show that one or many of these problems are part of depressive symptoms in about 40 to 50% of patients1, 2.
So, what is the connection between depression and sexual dysfunction? These studies fail to indicate whether the patient’s psychological state is responsible or if sexual dysfunction arose as a result of difficulties faced by the depressed person, nor even if the problem existed prior to the onset of depression. Furthermore, depressed patients are often prescribed antidepressants, whose known side effects include sexual dysfunction. So, how do we determine what is responsible for what?
More often than not, sexual dysfunction persists even though antidepressants suppress symptoms of the actual depression, helping the person to feel better. In some depressed people, taking antidepressants provokes sexual difficulties, which they hadn’t previously experienced even in the height of the depression.
Antidepressants and sexual problems
This hitherto poorly known side effect of antidepressants has been the subject of increased focus in recent years and is now better understood. A study demonstrated that, though only 14% of depressed patients spontaneously reported experiencing sexual dysfunction, 58% of them did when their doctors asked about it. Another survey revealed that while 51% of patients using antidepressants felt better, only 1% of them had noted an increase in their sexual interest2.
Although the majority of antidepressants may adversely affect sexuality, effects vary. Some medications reduce sexual desire while others decrease sexual arousal or the intensity of orgasm. As a matter of fact, certain antidepressants which are known to delay ejaculation are used in the treatment for premature ejaculation.
How do I know if my sexual problem is an antidepressant side effect?
If you’re going through depression, have been placed on an antidepressant and suffer from sexual dysfunction, you should be aware that:
- If your sexual problem appeared at the beginning of treatment, the drug is probably to be factored in;
- If, despite improved mood and the suppression of certain depressive symptoms, the sexual dysfunction which appeared at the onset of depression lingers, then your treatment might be responsible;
- If your problem already existed prior to the onset of depression, then your medication is presumably not to blame but if you see a sexologist, do mention the treatment.
In any event, you shouldn’t hesitate to broach this subject with your doctor, to find the best medication for you. There is no need to systematically put a fulfilled sexual life to one side due to depression.
One study suggested that sexuality remains of great interest to people suffering from depression. 75% of depressed people or those with a history of depression said they considered enjoying a fulfilling sexual life2 to be important or very important.
What can be done if the antidepressant is to blame?
One thing is certain: you should never discontinue antidepressant medication heedlessly. Your doctor will work with you to find the most appropriate solution5, 6 for your particular case, taking the following into consideration:
- It could be possible to reduce the dose to a minimum amount while remaining efficient;
- Side effects on sexual function sometimes disappear on their own within a few months;
- Not all antidepressants produce the same disruptive effects. It is sometimes possible to change to another therapeutic class;
- Your doctor may suggest that you take “therapeutic breaks”, i.e. leave off taking the medication over the week-ends, but this method isn’t adapted to every patient;
- Some anxiolytic drugs, such as Buspirone®, combined with selective serotonin reuptake inhibitors (SSRIs), can cause antidepressant-induced sexual dysfunction to disappear;
- Men with antidepressant-induced erectile dysfunction can in some cases, also use erection inducers in order to counterbalance this side effect.
Bear in mind that antidepressant-induced sexual dysfunction is treatable. Complementing medicated treatment with psychotherapy can help treat the depression, thus more quickly phasing out the use of antidepressant medication.
Sexuality had long been overlooked by therapists, but thankfully is now considered as a factor in a depressive person’s overall wellbeing. The quality of a depressed person’s sexual life is an important indicator that could either help or hinder their recovery from depression. So don’t be shy about it and even if your doctor hasn’t broached the subject, do talk about it!
1. “Dépression et troubles de la fonction sexuelle,” F. Ducrocq, L'Encéphale, 1999, XXV: 515-6
2. “The effects of antidepressants on sexual functioning in depressed patients: a review,” J. M. Ferguson, J. clin. Psychiatry, 2001; 62 (suppl 3) p 22-34
3. “SSRI-induced sexual dysfunction: Fluoxetine, Paroxetine, Sertraline and Fluvoxamine in a prospective multicenter and descriptive clinical study of 344 patients,” Montejo-Gonzalez Al, Llorca G, Izquierdo Jo and al, J Sex and Marital Therapy 1997, 23(3)p176-94
4. “Sexual dysfunction secondary to depressive disorders,” B. Barlik, J. H. Kocsis, R. Legere, J. Villaluz, A. Kossoy, A. Gelenberg, The journal of gender-specific medicine 1999, vol 2, N° 2 p 52-60
5. “New directions in the treatment of antidepressant-induced sexual dysfunction,” A. J. Rothschild, Clinical therapeutics, 2000, vol 22, suppl A, p 42-61
6. “Strategies for the treatment of antidepressant-related sexual dysfunction,” J. Zajecka, J. Clin. Psychiatry 2001, 62 suppl 3 P 35-43
Copyright © 2010 Doctissimo
Posted 20.02.2012
Get more on this subject…
