ANTIDEPRESSANTS AND WOMEN: THE SEXUAL SIDE EFFECTS
By Dr. Pega Ren

- Originally published on DrKoop.com

Antidepressants can bring sunshine back into a life filled with gloom. They can help us cope with the inevitable ups and downs of life. They can restore us to balance, even out our sleeping and eating patterns, and turn
desperation into calm. Few would argue their value.

No drugs, however, are without side effects, and antidepressants are no exception. A new breed of the drugs, called SSRIs (selective seratonin reuptake inhibitors), are better tolerated by most and produce fewer
troublesome side effects. Sexual function is impacted, though, even by SSRIs. If we are prescribed these drugs, we must educate ourselves about how they will affect us, both positively and negatively. The relief brought by antidepressant therapy may be tempered by unwelcome sexual changes.

For women, desire and arousal patterns may be unaffected or even enhanced. It makes sense that when we feel better, we more easily respond to erotic stimuli. As we reconnect with those around us, we welcome
sexuality once again. We glory in the feelings that have so long been subdued and gratefully embrace desire. With depression lifted, we rejoice as our bodies remember the pleasure of sexual connection and arousal. It is true that our sexual response patterns may be altered, but for most, arousal is attainable and consistent.

It’s not all good news, however. SSRIs often affect our orgasmic response. What this means in practical terms is that, although we are feeling like life is being restored, we are reconnecting with those we love, and we
are experiencing desire and arousal again, orgasm may be elusive. We get close, closer, closest.....but can’t experience release. If we make a chart of a sexual encounter, we see something that looks like a mountain. Orgasm is the peak. SSRIs tend to leave the mountain intact, but shear off the summit. At first, we may not mind, for we have recaptured, after all, the ability to make the invaluable human connection that sex is. But repeated ‘failures’ to enjoy orgasm are frustrating, and our partners may react as well. We ask ourselves, “What’s wrong with this picture?” The answer is that antidepressants may alter the response pattern so that orgasm simply doesn’t happen. What can we do about this? Different women respond to different
interventions. We need to experiment to see what works for us. We can try:

- Skipping a single dose. Once our dosage requirements are established, some women find that eliminating a pill before an evening of lovemaking enables our bodies to attain orgasm. Although this sounds simple enough, we must use caution here. Antidepressants work best when our bodies receive a constant supply, and NO medication should be manipulated incautiously. Repeated skipping can, indeed, diminish the capacity of the drug’s efficiency. We must be extremely cautious with this.

- Trying another antidepressant. Each drug is specifically formulated. Dosages differ, as do side effects.
There are now many options available, and new drugs are being developed and released all the time. Our doctors can work with us to find the prescription that gives us the best relief with the fewest side effects.

- Varying the time of ingestion of the drug. It may be that taking our medication in the morning, rather than in
the evening, allows our bodies to accept sexual stimulation to the point of orgasm. This option is, unfortunately, the least likely to be effective, especially with long-term use of the drugs.

Our doctors must be involved in this investigation. Antidepressants are powerful drugs (that’s why they work!) and we are patients, not pharmacists. No dosage should be manipulated without sufficient dialogue with our health care providers. That means that we must talk with our doctors about how the medications are affecting us. We must be bold in bringing up our sexual concerns. If our doctors silence us or fail to respond appropriately, we need to seek physicians who will listen and support our search for the best drug regimen available to us.

Recovering from depression is like coming back to life after a long, dark absence. Sexuality is far too important a part of our lives to ignore or dismiss. If we take the responsibility to keep informed, surround ourselves
with empathetic health care providers, and insist upon the best quality of life available to us, we can be assured of full, rich sexual interactions. We may not experience the same sexual responses as before depression, but we can strive for the best possible outcome given the hand we have been dealt. The future looks brighter all the time. Seize the day!

© 2001. Pega Ren, Ed.D. All Rights Reserved.