Antidepressants carry the risk of sexual side effects for some patients. Some antidepressants, however, have less of a chance of causing sexual problems than others. Research continues and is sometimes conflicting. The medications may also cause other side effects, especially when patients first take the drugs. Doctors have methods to reduce or eliminate sexual or other side effects for many people.
Bupropion
A study of 6,297 patients in 1,101 primary care clinics throughout the United States found that bupropion had the lowest risk for sexual dysfunction when compared with other antidepressants. Bupropion had a 22 percent sexual dysfunction rate among the patients, according to research published in the April 2002 issue of the "Journal of Clinical Psychiatry." Among patients taking bupropion sustained-release medication, 25 percent experienced sexual dysfunction. Selective serotonin reuptake inhibitors, or SSRIs, mirtazapine and venlafaxine extended-release had the highest rates, ranging between 36 and 43 percent. The researchers report that people taking SSRIs or venlafaxine extended release medication have a four- to six-times greater risk of having sexual dysfunction than patients taking bupropion sustained-release antidepressants.
Mirtazapine
Although mirtazapine had high rates of sexual dysfunction in the earlier study, MayoClinic.com reports that bupropion and mirtazapine are the antidepressants with the lowest rate of sexual side effects, citing research published in the April 2009 issue of the "Journal of Clinical Psychopharmacology." Mirtazapine treats depression by increasing chemical activity in the brain to help maintain mental balance, MedlinePlus states.
Nefazodone
In the same study of 6,297 patients, which included 4,534 women and 1,763 men, nefazodone ranked third behind the bupropion antidepressants, with 28 percent of patients experiencing sexual dysfunction. Nefazodone also had a low rate of sexual dysfunction when compared to other antidepressants in a 2001 study by University of Virginia researchers, according to Psych Central. The drug works effectively for many depression patients by increasing levels of certain brain chemicals to achieve a mental balance.
Adjusted Medications
Switching medications or adding a second antidepressant during treatment may lower sexual side effects, MayoClinic.com reports. Adding bupropion or the anti-anxiety drug buspirone may ease sexual problems for some patients. Adding sexual enhancement medications may also solve sexual difficulties for people taking antidepressants. Sildenafil, a drug to improve sexual function, may improve the sexual problems caused by antidepressants in some women, according to MayoClinic.com.
References
- "Journal of Clinical Psychiatry": Prevalence of Sexual Dysfunction Among Newer Antidepressants
- MayoClinic.com: Antidepressants: Which cause the fewest sexual side effects?
- Psych Central: Which Antidepressants Cause the Least Sexual Side Effects?
- National Center for Biotechnoloogy Information: Bupropion
- MedlinePlus: Mirtazapine
