Sexual side effects, including erectile dysfunction (ED), are common with some medications. Some of the commonly prescribed antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SSRIs), are no exception.
In this article, we’ll discuss which antidepressants are least likely to cause erectile dysfunction and what to do if sexual side effects, including erectile dysfunction, occur.
Which antidepressants are known to cause sexual side effects?
SSRIs are the first-line antidepressants prescribed for many people; These are some of the most effective antidepressants available. SNRIs are also effective.
While both types are helpful, they can cause sexual side effects, including erectile dysfunction. Examples of SSRIs are escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft), and duloxetine (Cymbalta) and venlafaxine (Effexor) are examples of SSRIs. Another type of antidepressant, the tricyclic antidepressant (TCA), is used less often but can also cause sexual side effects.
If someone is taking an SSRI or SNRI but thinks the sexual side effects are getting worse, it is possible to reduce the dose of the medicine to see if the side effects improve. Another potential strategy is to switch to another SSRI or SNRI to see if the side effects are more manageable. However, if an SSRI or SNRI ultimately cannot be used for reasons such as sexual side effects, there are better options for antidepressants.
What are the common sexual side effects with antidepressants?
The sexual side effects of antidepressants can affect anyone. The specific side effects can vary from person to person and also depend on the drug and dose used.
In studies looking at the sexual side effects caused by SSRIs, researchers found that up to 80% of people taking SSRIs experienced some form of sexual side effect. In other studies, researchers found that over 60% of patients treated with antidepressants had some type of sexual side effect. The specific frequencies vary by drug, and several other studies have been done to show how common sexual side effects are from drug to drug.
In general, the most common sexual side effects of antidepressants include decreased libido, decreased orgasm, and erectile dysfunction. Altered orgasm can include decreased orgasmic intensity, orgasmic delay, or orgasmic deficit. Erectile dysfunction refers to the constant difficulty in getting or maintaining an erection in order to achieve satisfying sex.
Erectile dysfunction is reported by 25% of men under 40, 40% of men after 40 and 70% of men after 70. Although various sexual side effects can occur with the use of antidepressants, erectile dysfunction is a central topic of discussion. Below.
Which antidepressants are the least likely to cause erectile dysfunction?
There are many antidepressants. Although SSRIs and SNRIs are often used as first-line alternatives, some people may need to use another antidepressant because of possible side effects, such as erectile dysfunction.
Here are six alternative medications that may be considered for people who have sexual side effects, including erectile dysfunction, along with other antidepressants.
Bupropion
Bupropion (Wellbutrin) is an atypical antidepressant that works differently from SSRIs and SNRIs; It works by increasing the amount of dopamine and norepinephrine in the brain. It is a tablet that can be used to treat depression and seasonal affective disorder. Bupropion is often a medication for people with erectile dysfunction or other sexual side effects caused by SSRIs. It also works the same way as SSRIs.
Bupropion is sometimes used in addition to SSRIs to treat SSRI-induced sexual dysfunction, but can also be used on its own as a possible substitute. The American Psychiatric Association (APA) states that bupropion is recommended for managing possible sexual side effects such as arousal problems, dysfunction
Selegiline
Selegiline (Emsam) is an antidepressant which is an inhibitor of monoamine oxidase B (MAOI B); It works by stopping the breakdown of chemicals in the brain such as serotonin, norepinephrine, and dopamine. It is a patch that is applied to the skin once a day and used to treat depression.
Although selegiline is also available in generic tablet and capsule form, the patch is only a brand name product. Unlike patches, selegiline tablets and capsules are not approved for the treatment of depression.
In clinical trials, the sexual side effects of selegiline patches were comparable to those of placebo. In people who used selegiline patches, less than 1% of people had erectile dysfunction, whether they used selegiline patches or a placebo. Abnormal ejaculation (1%), decreased sexual desire (0.7%), and lack of orgasm (0.2%) were also rare in people using selegiline patches.
While MAO inhibitors such as selegiline can work similarly to other antidepressants and sexual side effects may be more acceptable, selegiline is often the last resort due to the safety risks associated with the drug.
Many drug interactions are possible with MAO inhibitors, and serotonin syndrome is a cause for concern, a serious condition that can occur when serotonin levels rise too much and cause tremors, high fever, changes in heart rate or heart rate. convulsions. A hypertensive crisis, an episode of very high blood pressure, can also occur.
Nefazodone
Nefazodone (Serzone) is an atypical antidepressant in the same class of drugs as trazodone (Desyrel); It works by increasing the levels of serotonin and norepinephrine in the brain. It is a tablet used to treat depression.
Nefazodone usually does not cause sexual side effects, including erectile dysfunction. Although nefazodone may be an option for some people with sexual dysfunction, it is often avoided due to the high risk of liver damage. Common side effects can include headache, drowsiness, dry mouth, nausea, and constipation.
Regardless of the medication in question, the choice of antidepressant is a choice that varies from person to person. Talk to your health care provider if you want to start or switch to an antidepressant.
Should I stop taking an antidepressant if it is causing erectile dysfunction?
You should not stop taking your antidepressants without talking to your healthcare professional. If you suspect that your medication may be causing erectile dysfunction, you have several options to consider.
Sexual side effects, such as erectile dysfunction, sometimes improve 2 to 8 weeks after starting a new antidepressant. If possible, waiting may improve side effects while still giving the medicine more time to work. If this does not help, your healthcare professional may try reducing the dose of your medicine, switching to another antidepressant, or treating erectile dysfunction with medicines such as sildenafil (Viagra) or tadalafil (Cialis). .
If an antidepressant is suddenly stopped without first consulting your health care provider, withdrawal symptoms from the antidepressants may occur. Withdrawal symptoms may go away over time, but can include:
- Dizziness
- Nausea
- Tired
- Muscle pain
- shivering
- Anxiety
- Irritability
If you need to stop taking an antidepressant, your healthcare professional may recommend that you gradually reduce your dose over time to avoid withdrawal symptoms.
Conclusion
Although SSRIs and SNRIs are commonly prescribed as antidepressants, they are known to cause sexual side effects such as erectile dysfunction. For people who want to avoid these side effects, antidepressants such as bupropion, mirtazapine, and others may be a good choice.
If you think your medicine is causing erectile dysfunction, you have several options. Until you talk to your health care provider, it is important that you continue to take your medications as directed.