How Antidepressants Affect Libido and What to Do About It
Over the last six years, antidepressant prescription rates have increased by 35%. While these medications can do wonderful things to improve mental health, many people report sexual side effects, with a top concern being decreased libido.
Understanding why antidepressants cause sexual side effects can help you determine a path forward, whether that’s choosing to take the medication in the first place or adjusting your prescription. Additionally, there are steps you can take to address these side effects and improve your libido, which we’ll discuss below.
How Do Antidepressants Work?
There are several classes of antidepressants, each of which works differently and can affect sexual function in different ways. That said, SSRIs (selective serotonin reuptake inhibitors) are typically the most problematic for libido.
SSRIs work by increasing the levels of serotonin in your body. Serotonin is a neurotransmitter that influences mood, emotion, and sleep, among other things. As a neurotransmitter, it’s released in the brain to deliver a message between nerve cells.
SSRIs stop serotonin from being reabsorbed by the nerve cells after delivering its message, which allows for greater levels of serotonin. All of this serotonin can then pass more messages to additional nerve cells. With these increased levels, you feel less anxiety and a greater sense of calm.
Unfortunately, when serotonin is increased, other hormones are decreased. This includes dopamine, a hormone and neurotransmitter that’s critical for sexual arousal. The brain typically releases a large dose of dopamine when you do something pleasurable - like taking part in sexual behaviors. With SSRIs blocking this dopamine release, your libido can suffer.
Effects of Antidepressants On Sex Life
Antidepressants have several sexual side effects. While the most commonly discussed one is a diminished interest in having sex, it isn’t the only side effect.
SSRIs can have the following side effects:
● Reduction in libido
● Vaginal dryness for women
● Difficulty getting an erection for men
● Difficulty sustaining arousal
● Discomfort during sex
● Difficulty reaching orgasm
There are also side effects that can indirectly affect your sex life. Antidepressants can cause nausea, dizziness, weight gain, and lethargy. These side effects can create both mental and physical discomfort, all of which may make sex less interesting.
How to Manage Sexual Side Effects of Antidepressants and SSRIs
It takes time, sometimes several months, to adjust to a medication and fully understand how it affects you. However, if you’re still experiencing negative side effects to your libido after your doctor’s prescribed waiting period, there are a few steps you can take to correct the issue.
Adjust the Dose
Lowering the dose of your medication can improve side effects. This likely won’t cure the issue entirely, as antidepressants can affect libido at any therapeutic dose. Still, it can make a difference in the severity of your side effects.
Talk to your doctor about lowering your dose. Your doctor may want to monitor you after lowering the dose to see how it affects you. Never change your dosage or stop taking your antidepressants without talking to your doctor first.
Switch Medications
SSRIs are not the only option for antidepressant medication. There are also SNRIs (serotonin and norepinephrine reuptake inhibitors), MAOIs (monoamine oxidase inhibitors), NDRIs (norepinephrine dopamine reuptake inhibitors), tricyclics, and tetracyclics.
Certain types of antidepressants are less likely to affect sexual function, and certain medications have fewer side effects. You may need to try a few different medications to find what works best for you.
Medications with the lowest levels of reported sexual side effects include:
● Bupropion (Wellbutrin)
● Vortioxetine (Trintellix)
● Mirtazapine (Remeron)
● Vilazodone (Viibryd)
Add a Medication
Additional medications can address the side effects of your antidepressant. For example, some doctors prescribe bupropion (an antidepressant) to boost libido and ease the sexual side effects of other antidepressants.
Your doctor may also recommend you take a medication that helps with sexual function. For example, tadalafil (Cialis) or sildenafil (Viagra) can alleviate erectile dysfunction. Additionally, buspirone (BuSpar) can alleviate anxiety, increase libido, and improve the ability to orgasm
Keep Communication Open
Aside from adjusting your medications, it’s important to be open with your partner. Keeping them in the loop on how you’re feeling can help them understand why you may not be interested in sex. Explaining how your lack of libido is unrelated to them can also help lower the sense of rejection they may feel.
It can also help to schedule sex during times when you feel the side effects least. Generally speaking, side effects weaken during the hours before you take the next dose. This may be the best window to schedule sex. Letting your partner know that you’re prioritizing sex and your relationship in this way can also help strengthen your bond.
Explore Other Sexual Issues
There may be other things getting in the way of your desire. For example, the weight gain from the antidepressants can affect your confidence. Or, stress at work or from other areas of your life can play a role. There may be other issues that are going unaddressed within your relationship.
Talking with a therapist can help you find and address these issues. Additionally, therapy can help you deal with the psychological issues that may arise from intimacy issues, like erectile dysfunction or vaginal dryness.
Bloom Therapy is here to help. Read more about our therapists and schedule a session today.
Resources:
https://my.clevelandclinic.org/health/articles/22581-dopamine
https://www.healthline.com/health/erectile-dysfunction/antidepressant-sexual-side-effects
https://www.health.harvard.edu/womens-health/when-an-ssri-medication-impacts-your-sex-life
Dr. Zairys Feliz, Ph.D., LCSW is a clinical psychotherapist. Zairys provides individual, couples and sex therapy using evidence-based approaches. She specializes in treating individuals and couples who have relationship or sexual concerns. Read full bio