- Why do antidepressants kill your sex drive?
That's what I'm gonna be talking about today.
I'm Dr. Tracey Marks, a psychiatrist
and I publish weekly videos
on mental health education and self-improvement.
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The medications that we use to treat depression
can be divided into two categories.
The ones that enhance serotonin and the one that don't.
The only one that doesn't though, is bupropion,
known by the brand name Wellbutrin.
Serotonin is a neurotransmitter or nerve chemical
that plays a role in regulating your mood.
But it also has affects other nerves
that control other parts of your body.
For example, we actually have more serotonin receptors
in our gut than we do in your brain.
That's why nausea is a very common
side effect with these medications.
Unfortunately, high serotonin levels in your brain
interfere with your sexual behavior.
The sexual dysfunction that you can get is having little
or no interest, delayed climax, or inability
to have an orgasm at all, erectile dysfunction
and decreased sensation in your genital area.
Some studies have shown that this can happen
as frequently as 60 to 70%.
That's a lot of people affected.
The positive news is that this is often dose dependent.
So, that means the higher you go up on the drug,
the greater the chance symptoms will crop up.
Then if you lower the dose, the problem can go away.
As long as your depression or anxiety doesn't come back
with that lower dose, then that can be a good working
solution for you.
Also in about 10 to 20% of people, the symptoms go away
if you watch and wait and don't do anything,
or change the dose.
What are some other work arounds to this problem?
As it turns out, dopamine, another neurotransmitter,
enhances sexual activity, especially sexual interest.
Wellbutrin is an antidepressant
that increases dopamine and norepinephrine.
So if you have depression, but you don't have much anxiety,
taking Wellbutrin as your antidepressant
can eliminate this problem.
But if you do need to take a serotonin agent,
sometimes adding Wellbutrin can reverse the sexual side
effects of your Lexapro or whatever serotonin agent
that you're taking.
This is not a change you can make yourself,
but you can raise this issue with your doctor and see
if he or she thinks that'd it'd be a good solution for you.
If the Wellbutrin addition doesn't work for you,
or you can't take Wellbutrin for some reason,
then what do you do?
Sometimes adding a medication like Buspar can help.
Buspar is for anxiety, and the reason
that it helps is complicated, but suffice it to say
that it activates a receptor that can offset this problem.
Two more possibilities, or two more solutions
are Cyproheptadine, also called Periactin,
is an antihistamine that is often used to treat nausea.
But it also has some serotonin blocking properties.
One of the downsides though is that it can be sedating,
and this may not work so well if you're trying to take
it as a pre-sex preparation.
The herb Ginkgo biloba increases blood flow
to the genital organs and so that may help with arousal.
But as with most over the counter remedies,
the results of these can be hit or miss.
Now if it happens with one antidepressant,
it's not a given, or an automatic,
that it's gonna happen with another one.
So a last solution could be to try
a different antidepressant.
But this depends on whether it's worth
it to you to start over with something else.
And you are at risk of having your depression
or your anxiety return if you switch to another drug
that's not as effective in treating your depression.
That's it, thanks for watching.
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