Anxiety and depression often go hand in hand. More than 30 percent of American adults have anxiety and another 10 percent have some form of depression.
With nearly half the nation affected by one or both of these conditions, many are using medications to keep them in check. Some of these, such as Prozac, Lexapro and Zoloft, are selective serotonin reuptake inhibitors (SSRIs).
SSRIs are commonly prescribed to help people living with anxiety or depression. Unfortunately, there may be a caveat to these medications: sex can be significantly affected.
SSRIs: A Brief Overview
SSRIs create a lasting change to combat anxiety and depression by limiting serotonin uptake. Low serotonin levels cause mental health issues, so SSRIs serve as a way to bring the brain back into a more normal, healthier serotonin range.
These effects take time to kick in, but the idea is that the right combination will last in the long run. While raising serotonin levels decreases the effects of depression and anxiety, serotonin also causes issues in the process of sexual desire and action.
SSRI medications include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- paroxetine mesylate (Pexeva)
- sertraline (Zoloft)
- vortioxetine (Trintellix, formerly called Brintellix).
Additionally, it's important to note that if taken while pregnant, Paxil may be linked to birth defects.
SSRIs and Sex
Since 1997, studies from Harvard, Psychological Journals and Pharmacological Reviews have found links between SSRIs and a variety of sexual dysfunctions. However, sometimes sexual problems may be unrelated to SSRIs.
About 35 percent to 50 percent of people with untreated major depression experience some type of sexual dysfunction prior to treatment, according to Harvard Health.
Some of these dysfunctions that can be related to SSRIs include:
- Decreased libido
- Decreased lubrication in women
- Erectile dysfunction in men
- Inability to reach orgasm
- Inability to sustain arousal
- Increased time/effort required to reach orgasm
- Painful ejaculation
- Priapism, or constant erection
These connections were not immediately acted on, and some doctors still don’t address this possibility. If the doctor doesn’t bring this up the patient should ask about all the potential side effects of an SSRI.
Dealing with Anxiety and Depression
SSRIs are powerful tools to combat depression and anxiety, but because of their effects on intimacy, many people stop taking them. This creates a relapse of depression or anxiety.
Instead, the following tips have been suggested by Harvard Health:
- Lowering the dose
- Scheduling sex for times when the medication is not strongest
- Taking a "drug holiday"
- Switching medications
- Adding a drug like Cialis or Viagra
Talking to a doctor about these options, and being open and honest with your partner, can help to find a solution to SSRI induced sexual issues. Though it can seem awkward and difficult, experimentation and persistence can ensure that consumers do not have to choose between mental health and sexual ability.