Antidepressants and sex drive

Being depressed may make you go off sex but it could be your antidepressants that are to blame. A loss of sex drive is a pretty common side effect with some widely prescribed anti-depressants known as SSRIs - selective serotonin reuptake inhibitors.

It hard to put a figure on how many people do experience sexual dysfunction as a side effect of taking the medication as estimates vary. One study in the Journal of Sex and Marital Therapy suggested that when specifically asked more than half of patients said that SSRIs had affected their sex lives. However, only 14% reported a problem without being prompted.

Depression by its nature makes people feel low and hopeless and take no pleasure in activities they previously enjoyed. It's sometimes hard to pinpoint if it's the condition that's affecting libido or the treatment.

Recognised side effect

"Sexual dysfunction is well recognised as a potential side effect of SSRIs," says Dr Cosmo Hallstrom, consultant psychiatrist and fellow of the Royal College of Psychiatrists.

"Most patients don't complain, either because they are British and don't want to discuss such matters, or because when you are depressed the quality of your sex life is the last thing you are worrying about, and also because depression itself quells your sex drive so they may not make the connection," says Dr Hallstrom.

He says if, however, the treatment is making you feel better you may be prepared to put up with it but if it is a problem then you can change treatment.

Why does it happen?

SSRIs work by blocking the reuptake of the chemical serotonin in the brain, which increases the levels of serotonin available. Serotonin is known to influence mood, but exactly how SSRIs improve depression isn't really clear.
Antidepressants have different effects on different people.

"If they don't suit there are alternatives – non-SSRIs which work in a different way. Antidepressants have the same efficacy but different side effect profiles," adds Dr Hallstrom.

Commonly prescribed SSRIs:

• Dapoxetine (Priligy)
• Fluoxetine (Prozac or Oxactin)
• Citalopram (Cipramil)
• Escitalopram (Cipralex)
• Fluvoxamine (Faverin)
• Sertraline (Lustral)
• Paroxetine (Seroxat)

Sexual dysfunction

Different types of sexual dysfunction have been reported as side effects of SSRIs.

They include decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, an inability to ejaculate, impotence and general sexual dissatisfaction.

If you are on an SSRI and are experiencing problems with your sex life, it could be the treatment. Talk to your GP to see if a different treatment might be more suitable.

The importance of sex

The importance of sex when it comes to mental health shouldn't be underestimated.

Having good sex makes you feel closer to your partner and releases feel-good hormones that can make you feel happier. If you are depressed sex can make you feel better.

An informed choice

All patients should be aware of any potential side effects of their treatment from the offset, but in reality that doesn't always work.

"To what level you tell your patients about the low sex drive side-effects depends on the individual patient," says Dr Hallstrom. "If they are very depressed telling them it might mess up your sex life may not be the best idea."

It's understandable that doctors don't want to go through all of the negatives as they don't want to put patients off taking the treatment. Also a person taking antidepressants may not suffer any side effects anyway.

It's best if patients are aware that sexual dysfunction is a potential side-effect so if they experience it they know what may be causing it and can seek medical advice.