Sexual Side Effects of Antidepressants and Mood Stabilizers

[IAmStillHere]

I will be seen next week at a hospital for help with my menanl health and i'm pretty sure they will suggest antidepressants or mood stabalizers.

I wanna know how many people actually experience sexual problems on them.
when I read the studies I never understand well. Is it like 1 or 2 percent of people only who have them and what about other side effects?

thank you

 

[Retired]

Source: MayoClinic.com
from Daniel K. Hall-Flavin, M.D.

Question
Antidepressants: Which cause the fewest sexual side effects?My psychiatrist is recommending that I take an antidepressant for my depression. But I'm worried about the sexual side effects. What can be done to prevent or minimize such side effects?

Answer
Sexual dysfunction is a frequent side effect of antidepressants. So your concern is understandable. The risk and severity of sexual side effects depends on the individual and the specific type and dose of antidepressant. Common sexual side effects include reduced sexual desire, erectile dysfunction, and difficulty achieving orgasm or ejaculation.

According to a 2007 overview of research, the antidepressants with the lowest rate of sexual side effects include:

• Bupropion (Wellbutrin), a norepinephrine and dopamine reuptake inhibitor (NDRI)
• Nefazodone, a combined reuptake inhibitor and receptor blocker
• Mirtazapine (Remeron), a tetracyclic antidepressant
• Duloxetine (Cymbalta), a serotonin and norepinephrine reuptake inhibitor (SNRI)

Selective serotonin reuptake inhibitors (SSRIs) — such as fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft) — all have a high rate of sexual side effects. But some research suggests that Paxil is more likely to cause sexual dysfunction than are other SSRIs.

Tricyclic antidepressants — such as amitriptyline, clomipramine (Anafranil), amoxapine and desipramine (Norpramin) — have a lower rate of sexual dysfunction than do SSRIs. However, some research suggests that clomipramine and amoxapine have a higher rate of sexual side effects than do other tricyclic antidepressants.

Exactly how antidepressants interfere with sexual desire and function remains the subject of ongoing debate and investigation. Unproven theories abound. For example, some blame the sedating effect of certain antidepressants for dampening sexual desire. Others speculate that antidepressants cause chemical changes in the parts of the brain that regulate sexual desire and function. Complicating all of this is the effect of depression itself in decreasing sexual desire and function.

It's impossible to predict which individuals are most likely to develop sexual side effects while taking an antidepressant. In some cases, sexual side effects may improve once your body adjusts to the medication. But in others, sexual side effects may last for the duration of treatment. If you experience sexual side effects while taking an antidepressant, consider these strategies:

• Talk to your doctor about the possibility of changing your dose.
• Consider taking a medication that requires only a once-a-day dose, and schedule sexual activity before taking that dose.
• Talk to your doctor about adding or switching to an antidepressant that may counteract sexual side effects, such as bupropion (Wellbutrin) or mirtazapine (Remeron). The anti-anxiety drug buspirone (BuSpar) also may reverse antidepressant-induced sexual dysfunction.
• Talk to your doctor about taking a medication intended to directly treat sexual dysfunction.

How well these strategies might work depends on the specific drug and your individual circumstances. If sexual side effects are troublesome, talk to your doctor before discontinuing your medication or trying unproven remedies.

 

[IAmStillHere]

thank you

 

[David Baxter PhD]

Luvox (fluvoxamine) seems to be pretty good in that respect, too.

However, there's really not much to go on to predict individual response to any of the SSRI or SNRI medications - you may need a little trial and error. Even if a parent or sibling experiences a certain side-effect from a medication, it doesn't mean that you will. The reality is that most people don't experience side-effects and those who do can usually resolve the issue by switching to a different SSRI. Since the specific side-effect you experience will give your doctor more in formation as to how your body/brain responds, most people can get the benefits without the side-effects by the second or third SSRI they try.

As an example, Effexor is one of the medications know for two side-effects: changes in sleep and changes in sexual function. But of those who have problems with changes in sleep or fatigue, about as many people experience excessive sleepiness as experience insomnia (and again about 80% don't have either side-effect). Similarly, while Effexor is more likely than some other SSRIs to produce some sort of sexual side-effect, most don't have this problem and for those who do predicting exactly how it will affect sexual functioning is almost impossible: while some people experience reduced libido, delayed orgasm, or anorgasmia on Effexor, other experience heightened libido and improved orgasm (one female client who was previouslay anorgasmic for a number of years became multiorgasmic on Effexot).

The best advice, I think, that anyone can give you is to work with your doctor and be prepared for a little trial and error.

Also note that if you do experience an unwanted sexual side-effect. some people find that combining Wellbutrin (which isn't usually the best antidepressant on its own) with an SSRI may help to counteract the unwanted side-effects of the SSRI.