Anti-depressants - sexual dysfunction

[WillWorkForFood]

The sexual dysfunction that can often accompany the use of SSRIs is widely reported and I have suffered this problem on Sertraline and Fluoxetine.

My GP has just switched me on to Citalopram, however I fear it will result in the same.

I've done quite a bit of research into SSRIs and have a theory I want to try and test...

Has anyone who has experienced sexual dysfunction (reduced libido, lack of sensation, inability to climax etc) on one SSRI, switched to a different SSRI to then not suffer dysfunction?

My theory is that whilst not everyone suffers dysfunction on SSRIs, those that do will suffer it on them all, irrespective of brand, as it's the reaction to increased serotonin levels, no matter what drug achieves this that is causing the dysfunction; i.e, you're either susceptible to increased serotonin or you're not - at least as far as dysfunction is concerned.

What I'm looking for is someone that has experienced dysfunction on one SSRI, but switched to another and not suffered dysfunction, i.e disproving my theory.

Anyone?

Thanks in advance.

Could you try a different type of antidepressant? I’m on a tricyclic (dosulepin) and haven’t experienced these problems but I only managed 2 days on a SSRI so not sure how that would have affected me long term.

From what I've read, due to cost issues to the NHS and likelihood of success, I believe GPs are encouraged to exhaust all SSRI/SNRIs before trying other types of meds.

My GP is keen to keep trying SSRIs until I find one that works. I'll happily deffer to her medical expertise/experience, however I don't hold out much hope that they'll be any different.

I was just wondering if anyone has suffered on one SSRI but not on another - just to give me some hope in the short term.

I did on Citalopram but did not on the SNRI Venlafaxine if that helps.

Sometimes people can get prescribed Buproprion (Zyban) to counteract those effects but I don't think a GP can do that, especially as it's off-label as it's meant to help people quit smoking.

Thanks, that's good to know.

Yes, Bupropion (Zyban, Wellbutrin) is widely reported to help with depression, help lose weight and does not have any sexual side effects - in fact in some cases can increase libido/sensation - a happy/skinny/sexy pill.

I've researched it to death and driven myself mad with dead ends trying to find a way to get it on the NHS, but as you say, it's only prescribed under secondary care from a GP referral.... which won't happen unless all other avenues have been exhausted - hence the merry-go-round of trying all the (cheap) SSRIs first in the hope of finding one that works.

It is encouraging to hear that Venlafaxine didn't have that impact with you, although the come off experience sounds awful from what I've read?

The annoying thing with Bupropion is that it's the most prescribed AD in USA and Canada. This issue in the UK is cost, but nobody wants to admit it.They only use it for smoking cessation as it's a short term treatment and the benefits of getting someone to quit smoking will save the NHS more money in the long run.

I'll keep experimenting and play the system in hope of finding a positive outcome.

What many GPs don't realise is that whilst a SSRI might cure depression, the loss of sex life can have a serious impact on other areas of your life - marriage, self esteem, self confidence, overall well being etc, yet to some, this is considered an 'acceptable' compromise. Not if it makes you utterly miserable it's not.

Rant over...

I only got it when I was able to use private health insurance to go private. I didn't even have to ask for it - it was my doctor's first suggestion. He was suggesting all sorts of other things too I'd only read about on the Internet, mostly US forums - it was SUCH a relief to finally have "access" to such things beyond the carousel of identical SSRIs.

I'm only about four days into the buproprion so I have no idea if it is doing anything - I don't feel any different in any sense, good or bad or weird. Although I did have a large amount of breakthrough bleeding today, a week early and I am on the pill so I have no idea what that is all about. Apparently it can do that though, as I later found out.

For what it's worth, as I had to pay for my prescription it seemed to be about £1 a pill (daily, 150mg). So not outrageous compared to many medications.

You're right about the Venlafaxine and withdrawal though and I am not looking forward to finding out. I'm only on 75mg, only been on it a couple of months. However I don't think it's helping as I still feel anxious and depressed. And although some side-effects are better (less brain fog, nothing sexual) I am finding it much harder to get out of bed in the morning, and worst of all, I'm gaining 1-2lbs a week. When I realised I went on an immediate diet but all it's done is maintain my weight and I feel hungry all the time. I'm particularly annoyed as Venlafaxine is meant to be more likely to cause you to lose weight, not gain it!! So I'm going to see if I can get off it.

I completely agree with you though, on all of that. The side-effects can actually make things worse - citalopram trashed my memory and made my focus even worse, which meant my performance at work suffered and performance at work was one of the things that was originally behind my anxiety and feeling depressed. Not to mention a grumpy, unhappy husband does not do wonders for recovery. I can see it now - "So, you've lost your job and your husband has left you, but as you're feeling numb about it all, that's okay, right?"

Thanks fro your reply - I'm delighted you have found a 'route to market'.

I agree - I hear (read) too many times that sexual side effects should be tolerated just to get rid of the depression.

Not on my watch.

That might be an acceptable outcome for some, but to others, myself included, a healthy and active sexual relationship with my life partner is an essential part of who we are and the dynamic of our relationship - kissing it goodbye would cause depression!

Your last sentence hit the nail on the head.

Day two of Citalopram. I went straight from fluoxetine to this, so am yet to see whether the numbness downstairs recovers.

I've tried sertraline and citrolopram and both leave me unable to climax. My GP didn't consider this too bad a side effect to put up with

Clomipramine for me. Nothing in the downstairs department. Been on it for 7 years or so. It's like a blank, no desire to, it's going to work anyway so what's the point.

Sexual dysfunction is the biggest concern for men when they do the sexual activity with their partner, as a result, both man and woman not satisfied with intercourse and it badly affected on their relationship. But some medical help to solve or treated on male impotence or erectile dysfunction problem very effectively. Generic Viagra is one of them medicine help to boost blood circulation and gives harder, stronger and last longer erection during intercourse.

I used to struggle with this and then realised that the anti depressants weren't actually doing much for me - I felt no mental or physical changes in the slightest. So I stopped taking them altogether and looked at working on my mental health in other aspects and my sex life (and other areas) improved dramatically.

However, I understand that many rely on them so I do hope that you find a way to continue taking them and enjoy intimacy again as this is just me sharing my experience

Still waiting for my psych referral to explain what's what.

No joy downstairs - no interest, no desire, no sensation - just totally switched off and disconnected. Probably worse than the fuoxetine, but at least I can sleep now.

The sexual issues are not sustainable as my relationship will fail and neither of us want to be in a sexless relationship. This in itself is worsening the depression, however the depression is so bad, I don't want to come off the pills.

The pills still aren't working - no uplift whatsoever. I started on 10mg, about 7 weeks ago, then with no change, upped to 20mg for about 4 weeks, still no change, so have no gone up to 30mg. Let's see if that has an impact.

i was put on mirtazapine , as i mentioned i didnt want any sexual issues and its fine .

willwork i renamed sertraline (lustral) no-lust-at-all. My STBXH and I thought it was worth putting up with the lack of a sex life for the mental stability. But then, after definitely over a year, the 'lust' reappeared...with a vengance.

I think it's worth putting up with the negative side effects, as every drug has side effects, and the sexual thing might correct itself in time.

I'm on mirtazapine now and couldn't be less interested in sex. I"d happily never ever have it again, but I'm not in a relationship so it isn't an issue!

I personally had no issues with Sertraline (although this gave me terrible acid reflux) or Fluoxetine but had no interest in sex (or anything but sleeping, to be honest) when I went onto Citalopram. I am not sure if this was because of the meds or because I was quite ill and had not yet had any success with counselling. Thankfully now I am off meds (for now!) things are back to normal.

It sounds like you're having a tough time OP-good luck, and I hope things improve for you soon.

I tried Mirtazapine and it didn't help with the depression whatsoever. Great for anxiety, but not depression, for me anyway.

So far, Sertraline, Mirtazapine,Ffluoxetine and Citalopram have had zero effect on my depression. All the side effects, none of the benefits.

Every drug I’ve taken for depression had that effect on me, except mirtazipine but the mirtazipine made me eat my own body weight in sugar every day and sleep for 16 hours at a time.

It really sucks and combined with the other side effects, I just gave up taking anything (not that that is what I’m advising you at all.) It’s hard to live with.

This was a side effect I got initially with fluoxetine, bit that gradually diminished as I got used to them. And tbh the sexual side effects were easier to live with than the crippling depression which almost instantly got better when I started taking them. So swings and roundabouts really.

If you have no benefit from antidepressants despite trying many, you may have something like a personality disorder which typically doesn't respond to antidepressants. Depression is a transient state and ought not be a long term issue that is resistant to meds. Perhaps you should try coming off Ed's if they are causing little benefit?

My Dr says to continue and see if secondary care can prescribe something.

Got to try something though a giving up can;t be the fix?

By all measures and symptoms, it's classic textbook depression. I've had it for most of my adult life but it's been getting gradually worse to the point where it's now intolerable and life it just utterly miserable. I get no joy from anything anymore. Every day is a battle just to get to the end. Can't go on like this.

It is encouraging to hear that Venlafaxine didn't have that impact with you, although the come off experience sounds awful from what I've read?

I had no sexual dysfunction on Venlafaxine - or weight gain (other than gaining back the shed loads of weight I'd lost through lack of appetite when I became mentally unwell - and even though I was on a high dose for a few years, I had zero withdrawal effects when I came off it, but I did taper off very gradually over many months before stopping completely.

I was only on Sertraline for a few weeks before switching to Venlafaxine, and that was when I was so severely depressed that the idea of having sex never entered my head, so I don't know whether I would have had sexual dysfunction problems with that one either.

Erectile dysfunction is a sexual health problem that the person unable to achieve a strong erection at the time of sexual intercourse. Generic Viagra is the best option to solve it safely and effectively.

Hi

Another vote for Wellbutrin here if you can find a way to access it. Helped my libido and my temporary depression. However, citalopram is generally well tolerated, will take several weeks to know if it's going to help with your depression. I don't know the answer to your question about sexual side effects on all SSRIs.

@lesathomas The dysfunction was not being able to orgasm and there seemingly being a blockage between the pleasure receptors in by brain and my erogenous zones. Basically I switched off.

@HappyHedgehog247 Citalopram was actually the worst for me - totally dead from the neck down and left me feeling like an emotionless zombie. Life became a silent black and white movie.

I had my secondary care psychiatric evaluation and have been diagnosed with both Avoidant and also Obsessive Compulsive personality disorders. Apparently, the depression is a sympton of the personality disorder, rather than a stand alone condition.

Therefore it has been said that I need to address the personality disorders rather than papering over the cracks trying to mask the depression with ADs which will never cure the problem. A bit like constantly putting bandages on your feet when what you really need is a pair of shoes.

Before the diagnosis, I did ask about Wellbutrin and got told in no uncertain terms - absolutely no chance via the NHS. Not on the list, not happening. End of discussion. Moot to be honest, given the above.

I've now got to go through a lengthy period of CBT to try and address the personality disorders, which from what I've since read and researched could be a nightmare, as the two I have are notoriously difficult to treat with only limited success. The older you are, the more ingrained your mental hard wiring and the harder it is to undo all the structure and foundation.

The four drugs offered to help ease the symptoms whilst under treatment have a long list of horrible side effects including sexual dysfunction, so I'll not be going there.

If you can pay for therapy privately, it's worth the cost and sacrifices for the impact it can have on your life. Would not pick CBT for avoidant personality, I'd look for psychodynamic. Realise this may not be an option. You can do some good reading which may help.

I had lifelong depression/anxiety which went untreated until I got to the point of not being able to take it anymore. I thought I had avoidant personality but I've ended up being diagnosed with autism which sort of makes sense., In as much as being labelled with anything can. Based on my experience, has autism ever been considered with you? I would have hoped so, given what you've gone through but if not it could be worth looking into.

Also agree sexual dysfunction sucks. For me it's not horrendous but it does feel like it was a thing in life that could give a little joy now & then & it's had to be sacrificed.