Losing your Libido? Your antidepressant may be the cause

There can be many reasons for feeling a decrease in sexual desire including physical illness, stress, or depression.  The symptoms of depression including disruptions to sleep, a loss of energy, and a general disinterest in activities which used to bring pleasure are just some of the reasons why depression can be linked to a decrease in sexual libido.  In an article entitled, "Depression and Sexual Desire" (American Family Physician, August 2000) Doctors 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."  One might think that taking an antidepressant to combat the symptoms of depression might also increase one's interest in sex as you are feeling better emotionally.  Yet unfortunately this is often not the case.  Some antidepressants are notorious for not only decreasing sexual desire but also affecting sexual performance in a negative way.

I remember a conversation I had with a friend of mine over a cup of coffee.  My friend talked openly about her depression and how she began to take an antidepressant.  She told me she did feel better but that she had lost all interest in sex.  She added that it wasn't some big change as she didn't feel much like having sex when she was depressed either.  It does seem unfair that a pill which is supposed to help you feel less depressed can also rob you of your sex life.  Is it possible to use medication to decrease depression but not lose sexual desire and pleasure in the process?

The answer, according to the literature, is yes it is possible.  But the caveat is that you find the right antidepressant. 

One of the problems with finding the right antidepressant which does not cause sexual dysfunction is that many people feel uncomfortable discussing this issue with their doctor.  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.

Which antidepressants are most likely to cause a decrease in libido and/or sexual dysfunction?

According to Phillips and Slaughter (American Family Physician, August 2000) medications which are 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.