I remember talking to a friend once over coffee. She talked openly about her depression and how she was taking antidepressants. I asked her how this was working out. She told me that she felt better but had lost all interest in sex. But then she added that it wasn't some big change as she didn't feel much like having sex when she was depressed either. It stands to reason that when we are depressed we want to try to do things to help ourselves such as take an antidepressant. But must we lose our libido in the process? Is it possible to feel less depressed without sacrificing our sex life?
It seems an unfair choice to make, our emotional well being or our libido.
Yet it is true that depression in itself can cause one to experience a decrease in sex drive. In an article entitled, "Depression and Sexual Desire" (American Family Physician, August 2000) Doctor Phillips and Slaughter state that: "In one study it was found that more than 70 percent of depressed patients had a loss of sexual interest when not taking medication, and they reported that the severity of this loss of interest was worse than the other symptoms of depression." But it seems that loss of libido is not something a lot of patients discuss with their doctors and especially before beginning to take antidepressants.
If loss of sex drive or worries over sexual dysfunction is a concern of yours, please do discuss this with your doctor before beginning to take antidepressants.
Your doctor may then prescribe a medication which is less likely to cause sexual problems than not.
Which antidepressants are most likely to cause a decrease in libido and/or sexual dysfunction?
Phillips and Slaughter (American Family Physician, August 2000) believe that those drugs classified as SSRI's (selective serotonin reuptake inhibitors) have the most reports of sexual dysfunction from people taking them: "Up to one half of patients surveyed before and after starting therapy with the SSRIs fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa) and sertraline (Zoloft) reported a decline in libido with medication use." The literature seems to agree with this assessment and suggests that Prozac, Paxil, and Zoloft all have a high rate of sexual side effects. Of this group of SSRI's, some research suggests that Paxil is the drug most likely to cause sexual dysfunction.
Just to be clear, what is meant by sexual dysfunction? This can include a decrease or loss of sex drive, inability to achieve and sustain an erection for men, and failure to be able to reach orgasm for both men and women.
Thus, according to research the antidepressants most likely to cause sexual dysfunction and/or loss of libido include:
