Dear S&B: In general, do most SSRI [Selective serotonin reuptake inhibitors] antidepressants negatively affect one's sex drive? And why do some antidepressants cause prolonged erections?
In some ways this is a case of which came first, the chicken or the egg: Depression alone can depress sex drive. Selective serotonin reuptake inhibitors (SSRIs) are some of the most popular antidepressants. However, they have a notorious reputation for decreasing libido and causing sexual dysfunction.
SSRIs are named by their function -- they inhibit reuptake of serotonin, causing it to linger in the brain. But these side effects are not limited to depression patients, as decreased levels of serotonin are seen in many psychological disorders. SSRIs are commonly prescribed for anxiety, and Popular medications such as Prozac and Zoloft are SSRIs.
A review published in the Journal of Clinical Psychopharmacology in 1999 looked at several reports of SSRIs and sexual function, noting the most frequent sexual complaints of SSRIs were "delayed ejaculation and absent or delayed orgasm."
So what to do? Well there are a few options. After all, sexual health affects emotional health.
Possibilities include:
1. Decrease the dose of SSRI
2. Switch to a different SSRI
3. Switch to a non-SSRI antidepressant
4. Take a drug to counteract the side effects ... ever heard of Viagra?
5. Drug holidays
But never, ever change your dosage or skip taking your medication without first consulting your doctor!
Remember my last article about shrinkage? Well this is the opposite issue: You wonder why some antidepressants cause prolonged erections. I believe you are referring to a medical condition called priapism. Priapism is an erection that lasts greater than four hours. It is considered a medical emergency.
Note the emergency, meaning if this happens, get yourself to a hospital! This requires immediate surgical evacuation of blood in the corpora cavernosa. Priapism is noted with use of trazadone and is rare, occurring in approximately 1 in 10,000 patients.
Lisa Hermann is a Cavalier Daily Health & Sexuality Columnist. She can be reached at lisa@cavalierdaily.com or through the Sex & Balances submission page at cavalierdaily.com/sex.asp. This column is used for educational purposes only and is not meant to substitute advice from your doctor.
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