Category Archives: Side Effects

Antidepressants Without Sexual Side Effects

Worried about the side effects of sexual antidepressants? Do you want to reduce the effect of antidepressants on your sexual desire, erection and libido?

Antidepressants Without Sexual Side EffectsThe severity of sexual side effects depends on the individual and the specific type and dose of antidepressant.

For some people, sexual side effects are minor or may ease up as their bodies adjust to the medication. For others, sexual side effects continue to be a problem.

Antidepressants with the lowest rate of sexual side effects include:

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%.

Antidepressants Without Sexual Side EffectsWhen 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.

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Antidepressants most likely to cause sexual side effects include:

  • Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). However, selegiline (Emsam), a newer MAOI that you stick on your skin as a patch, has a low risk of sexual side effects.
  • Selective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs),which include venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta).
  • Tricyclic and tetracyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and clomipramine (Anafranil).

FDA Approves Antidepressant That Might Pack Fewer Sexual Side Effects

Lowered Libido After Treatment

Consistent evidence shows that, with the exception of bupropion (Wellbutrin), trazodone (Desyrel) and nefazodone (Serzone), antidepressant medications may cause a decline in libido or sexual functioning despite improvement of depression. 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. SSRIs also cause other sexual dysfunction that can affect libido and compliance.Antidepressants Without Sexual Side Effects

In a double-blind clinical trial of treatment with imipramine (Tofranil), phenelzine (Nardil) or placebo, it was found that 30 to 40 percent of patients taking either antidepressant reported a decline in sexual desire, while 6 percent of those taking placebo experienced the same effect.

Although the use of monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants to treat depression is on the decline, tricyclic agents are increasingly being prescribed for control of pain. When tricyclics are prescribed for pain, it is not uncommon for them to be used in conjunction with SSRIs.

SSRIs increase serum levels of tricyclics, so this combination may affect libido more than either alone. Table 1 summarizes the effects of various antidepressants and antipsychotics on libido.