Q. I have been taking Prozac for the past five years. I am happily married, but I've definitely noticed a downturn in my ability to achieve a climax.
My doctor recently switched me to Celexa to see if it would offer an improvement in that area. It hasn't worked, although both drugs have been very helpful with my depression.
Are there any anti-depressants that don't cause this particular side effect? Or is there some way to overcome this problem with orgasm?
A. When Prozac-like drugs were first introduced, no one knew how common sexual side effects might be. Pre-market testing suggested that such complications were relatively rare (2 to 16 percent). Now we know that sexual problems may actually range from 30 to 70 percent of patients.
Drugs like Celexa, Effexor, Lexapro, Paxil, Prozac and Zoloft are prescribed for anxiety, bulimia, depression, chronic fatigue syndrome, hot flashes, obsessive-compulsive disorder, PMS and post traumatic stress disorder.
Many people report that such drugs can reduce libido, interfere with arousal, delay or block orgasm and cause erectile dysfunction. Some describe a numbness or lack of sensation as “genital anesthesia.” If they do achieve orgasm they experience little or no pleasure in the act. A recent article suggests that sexual side effects may sometimes persist indefinitely, even after the drugs are discontinued (The Open Psychology Journal, Vol. 1, pp 42-50, 2008).
There are no obvious antidotes for this problem, though some doctors have tried drugs like Viagra. An antidepressant such as bupropion is less likely to cause sexual dysfunction. Discuss your situation with your doctor to see what solution might be appropriate.
