Can I have a good sex life if I'm on antidepressants?

Jan L. Shifren, MD
Reproductive Endocrinology
You don't need to sacrifice your sex life in order to treat depression. Some newer antidepressants -- including bupropion (Wellbutrin) and mirtazapine (Remeron) -- are less likely to cause sexual problems. There are reports that bupropion may boost sexual drive and arousal, as well as the intensity or duration of an orgasm, even in women without depression. Older medications, known as tricyclic antidepressants and monoamine oxidase inhibitors, don't usually cause sexual problems, but they have other potentially dangerous side effects. Your healthcare provider can help you sort out which medication is right for you.

If you're taking a selective serotonin reuptake inhibitor (SSRI), taking a lower (although still therapeutic dose) may help offset or eliminate sexual problems. In the past, healthcare providers sometimes recommended taking a "drug holiday," whereby you stop taking the medication for a few days before a weekend, if that's when you hope to have sex. However, the risk that your depression may return means this practice isn't such a good idea, and the approach has fallen out of favor.

Another option is adding a drug. In both men and women, Viagra may counteract sexual problems from SSRIs. A study in The Journal of the American Medical Association found significant improvement in erectile function, arousal, ejaculation, orgasm, and overall satisfaction among men who took Viagra to counteract sexual problems stemming from SSRI use. The same journal reported a study that found similar results in women. Nearly three of four women with sexual side effects from SSRIs who took Viagra said their sexual response improved. Yet another possible strategy is adding bupropion (Wellbutrin) to your treatment for depression. You may want to ask your healthcare provider for a referral to a psychopharmacologist to help you find the best drug or drug combination for your situation.

Sex therapists offer some suggestions for coping with side effects from SSRIs, such as taking extra time to relax and spending more time stimulating the genitals before intercourse. Women might try using a vibrator, reading erotica, or masturbating beforehand, as well.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.