The Boston Globe delivers an article today on a problem that many people don’t realize: antidepressants can decrease or eliminate sexual desire and interfere with a person’s ability to have orgasm.

It’s a problem that’s more common than originally believed. Pharmaceutical companies testing their drugs before release have stated only about 3-5% of people in their trials had sexual side effects. But now that the drugs are in widespread use, it turns out the problem is also widespread: about 10 times that number actually have experienced sexual side effects.

What to do? Knowing this, one of the first things I do with clients who come in with mood disorders or anxiety and who have not yet been diagnosed is to educate them about the pros and cons of taking antidepressants. I also give them a reasonable option: Try eliminating symptoms of depression and anxiety without medication. For mild to moderate cases, psychotherapy alone has been shown to be effective. I let the client know that we can revisit the issue of medication if there doesn’t seem to be any improvement after 6 to 8 sessions of psychotherapy.

Second, for those patients with moderate depression, I counsel them about taking the smallest but most effective dose. I also tell them that if they notice a change in their sexual interest for the worse, or have delayed or no orgasm, then they need to speak to the prescriber and make a switch quickly. That’s because the side effects can become permanent. Although the number is very small, I have definitely had people in my office who went off medication, only to find orgasm still difficult to attain, even months and months later.

In a sex therapy practice, it is somewhat rare to have a client come to us with severe mood or anxiety problems that have not been previously diagnosed. Mostly, we see them when they are already on medication. Sometimes they come in with complaints that are related to their medication. Once they realize that is the case, some clients chose to try switching. Others, having tried multiple medications already to find one that works, decide that they will live with low desire or delayed orgasm rather than risking a mood disorder that interferes with their ability to function.

One thing is certain: Physicians needs to take more care about prescribing antidepressants to counsel their patients about possible sexual side effects, and to carefully consider referring people for psychotherapy for mild to moderate problems, rather than immediately reaching for the prescription pad.

» You can leave a comment, or trackback from your own site.