YOUR SEXUAL FUNCTIONING
The sexual side effects caused by antidepressants have become more well known in recent years. Some drugs, like
Prozac, were approved by the Food and Drug Administration without any indication that they caused significant sexual
problems. In clinical trials conducted to receive FDA approval, the manufacturers of Prozac found that only 1.6
percent of patients experienced decreased libido and only 1.9 percent experienced sexual dysfunction. Soon after
Prozac was approved in 1988, however, psychiatrists began to find that sexual side effects were much more common,
so researchers started to study the problem. One study found that 62 percent of people who take Prozac or some
other SSRI can't achieve orgasm, and 75 percent of men have trouble maintaining an erection. (In fact, these medications
are now being prescribed to men who have premature ejaculation because they are so effective at delaying orgasm.)
As a student of the brain, I have not been surprised to learn that normal sexual functioning is the result of a
tightly connected, symphonic coordination of these chemical systems and hormones with one's psychological and social
environment. A significant disturbance in any aspect of this symphony will disturb your sexuality - and in the
long run your general well-being and health - to a greater or lesser degree.
The most recent research on how antidepressants affect sexual functioning points to the action of these medications
on certain chemical systems in the brain and spinal cord - neurotransmitters and receptors. It is clear that different
antidepressants affect different combinations of these neurotransmitters and receptors, causing one or more sexual
problems: decreased desire for sex, decreased sensation and pleasure, decreased erection or vaginal wetness, and
difficulty having an orgasm or full climax.
If you've suffered the debilitating effects of depression or some other medical condition, you may have forgotten
what it's like to have good, satisfying sex. In fact, some of my patients don't notice much of a change in their
sex lives after going on antidepressants because their sexual desires have been buried for so long. Frequently,
it will be your spouse or partner who brings the problem to your attention.
Please take my advice and listen to your loved one. Your mind-body pathways can't function optimally without sexual
vitality, nor can your love relationship. A growing body of research indicates that those who have an active, satisfying
sex life have improved health and longevity. Obviously, the benefits of sex extend beyond the bedroom to your mind,
body, and spirit. Do not let antidepressants rob you of this vital life force. Work the antidepressant survival
program fully and you will reclaim it.
A FOUR-STEP APPROACH TO
RECLAIMING YOUR SEXUAL VITALITY
The good news is that we now know much more about how antidepressants cause sexual dysfunction. And, as you've
no doubt heard, there are now readily available drugs that can restore full sexual function for most people. Beyond
Viagra, and its sibling medications now coming onto the market, there are other strategies that work for reclaiming
a healthy and vital sex life.
You may have skipped straight from the table of contents to this chapter, looking for a quick fix for your problem.
That's human nature - but starting with this chapter isn't necessarily the shortest path to a solution. Many of
my patients find that simply following the Fundamentals of good nutrition, exercise, and stress reduction has a
therapeutic effect on their sex lives. As I point out in the earlier chapters, good eating habits and increased
circulation from exercise, along with improved self-esteem and sense of physical desirability, are important components
of sexual vitality. And correcting the hormonal problems discussed in Chapter 8 often also has a very significant,
positive impact on desire and performance.
I've developed a four step program to help you reclaim your sexual vitality.
- Assess your sexual hormone levels and see if you need any supplementation.
- Evaluate the impact of your antidepressant on your sexuality and consider changing or adjusting your medication.
- Use herbal therapies.
- Use sexual enhancers, such as Viagra and other medications.
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WHOLE PSYCHIATRY
