Do antidepressants interfere with libido? Scientists separate fact from fiction
Most antidepressants warn of two potential side effects: low libido and difficulty reaching orgasm.
Peter, a 34-year-old man who lives in Oregon, knew this. This is exactly why he was not sure whether he wanted to take the antidepressants recommended by his psychiatrist.
âObviously I wanted to do something that would help my depression,â Peter said. Reverse. “But I didn’t want to waste my sex life in the process.” (Pierre asked not to be named for confidentiality reasons.)
Seth Norrholm, translational neuroscientist and expert in stress and traumatic disorders, says Peter’s concern is quite common.
âScientific journal reports and anecdotal case summaries have identified reluctance to take antidepressants due to sexual side effects,â Norrhold said. Reverse.
It’s a tough call: Antidepressants can save some people’s lives, but many don’t like the idea of ââsacrificing their sex lives either.
If you are wondering what is right for you, consider this: you have options. No one is affected by an antidepressant in exactly the same way, and no one will force you to stick to treatment that doesn’t work. Consider the research and what your body needs.
Here’s the science behind some of the biggest questions you probably ask yourself.
Do antidepressants reduce libido?
Many of them can. You know how almost every drug commercial seems to feature a full 30 seconds of people jumping through daisies while a narrator lists all the possible side effects? It’s because a lot drugs have a lot possible side effects.
” I did not want lose my sex life In the process.”
It is important to know about these side effects before taking any new medicine, but it is just as important to understand that not everyone will experience all of the side effects, if any. Low libido and difficulty reaching orgasm are possible. But it won’t happen 100 percent.
“As with most psychiatric, pharmacological and non-pharmacological interventions, the way one person responds to one drug relative to another is complicated,” says Norrholm.
It is difficult to know how common the sexual side effects of antidepressants are, as some people simply stop taking their medications and others may not want to report the side effects to their doctor.
25 to 50 percent of men report negative sexual side effects
With all of these caveats in mind, Norrholm says that between 25 and 50 percent of men who take antidepressants report negative sexual side effects.
If you experience sexual side effects after you start taking antidepressants, Norrholm says, all is not lost. âThere are many antidepressant treatments available as well as strategies for patients that can be implemented to deal with emerging side effects,â he says.
What are the sexual side effects of antidepressants for men?
Norrholm says it varies quite significantly depending on the individual, the class of drugs, and the psychiatric disorder being treated.
With that said, here are four common side effects:
- Increase or decrease in libido
- Difficulty cumming / ejaculating
- Difficulty maintaining arousal
- Erectile difficulties
Again, Norrholm points out, this won’t happen for everyone. âThe effects are very closely related to the dosage and how an individual’s body metabolizes the drug and how quickly and when tolerance to side effects of the drug occurs,â he says.
What if they do? You have options.
What to do if antidepressants negatively affect your sex life
Fortunately, there are a number of options if you experience sexual side effects with antidepressant treatment. Norrholm says these include the following:
- Change the antidepressant class to one with a side effect profile less likely to affect sexual function
- Dose modification of existing antidepressant treatment
- Assess contributing physiological factors
- Some research suggests that an increase with sildenafil (“Viagra”) or Tadalafil (“Cialis”) may help recover impaired sexual function.
Moreover, antidepressants are not the only treatment for depression. If you are unsure about taking medication, try talking to a therapist.
Getting some kind of help for depression is likely to improve your sex life, just because the side effects of untreated depression aren’t a picnic either.
Which antidepressants are less likely to have side effects?
Selective serotonin reuptake inhibitors and serotonin / norepinephrine reuptake inhibitors are drugs used to treat depression known as SSRIs and SNRIs. Popular SSRIs include, but are not limited to:
Norrholm explains that because serotonin plays a role in male sexual activity, SSRIs are more often associated with significant sexual side effects. These drugs increase the levels of the neurotransmitter serotonin in the brain by limiting its reabsorption by neurons in the brain. Raising serotonin levels, in turn, helps some brains deal with depression.
“There is less risk of sexual side effects with older tricyclic antidepressants as well as with the norepinephrine reuptake inhibitor reboxetine [âEdronaxâ], and bupropion [âWellbutrinâ], which acts on the activity of the neurotransmitters of norepinephrine and dopamine, âhe says.
Norrholm adds that while the precise mechanisms of these side effects are not entirely clear, âthere is no doubt that the change in serotonin neurotransmission [as in the treatment of mood and anxiety disorders with antidepressants] can profoundly affect sexual function.
The sexual side effects of untreated depression
Although the possible side effects of antidepressants can be intimidating, not Seeking treatment for depression can also be a below-the-belt disappointment.
âSome estimates are close to 70 percent. “
Norrholm says people seeking treatment for major depression often report sexual problems before undergoing any type of treatment. âSome estimates are close to 70 percent,â he says. Decreased libido is common in people with major depressive disorder because one of its main symptoms is that you no longer enjoy the activities that gave you pleasure.
According to the Johns Hopkins School of Medicine:
âOne of the main symptoms of depression is the inability to enjoy things that you normally enjoy, such as sex. People with depression also have low energy, feel bad about themselves, and may see their partners through a negative filter, which impacts libido.
Whether it’s because you’re depressed or on antidepressants, the neurotransmitters associated with pleasure are affected. While it may be a bummer, it makes sense that sex, which usually gives us pleasure, is affected by changes in these neurotransmitters.
When he started taking an SSRI, Peter’s fears were confirmed. Although the drug appeared to help the depression, his libido plummeted.
While he didn’t like the idea of ââgoing back to his doctor and talking about his penis, that’s exactly what he did. Her doctor lowered the dose of her antidepressant and within a week or two her libido returned to normal. Better yet, when it comes to depression, he “didn’t really notice a difference between the higher and the lower dose – both worked well.”
If you’re feeling down and considering taking medication, says Norrholm, the best thing to do is talk to a doctor, ideally a psychiatrist. âThey will be better informed about the treatment options available and will tailor the therapy to the specific case,â he says.
If you have depression, you don’t have to sacrifice your sex life to get help. There are more options than you might think. Talk to a doctor. This will not be the first time they have heard this concern.
DETOX is a Reverse series that answers the biggest questions about men’s mental health.
If you have any suggestions for a future Detox column, email katie.macbride [at] reverse [dot] com with “Detox” in the subject line.