Depression Medications: How Can You Get Your Libido Back?

A man hands his girlfriend a pill and a glass of water as they look into each others eyes.I often see people who are in despair because they no longer have much interest in sex—what a current client calls her “disappearing libido.” Is she depressed about this? You bet! Did she become more depressed when her medical doctor put her on an antidepressant to alleviate the depressive symptoms? Quite possibly.

It’s common knowledge that sexual intimacy often takes a big hit when people begin taking antidepressants. So wouldn’t you think that doctors would talk to people about side effects before they prescribed? They rarely do. One doctor that I know explained, “With an allotted 15 minutes max, do you think I’m gonna ask this patient about her sex life? No.”

I guess this medical professional doesn’t read the Johns Hopkins Health Alert (JHHA). Recently, they reported that sexual dysfunction is a potential side effect of all classes of antidepressants. The Johns Hopkins folks claim that between 30% and 70% of people who take antidepressant medications experience sexual problems, which can begin as early as the first week. Now that is depressing, isn’t it?

Of course, my view as a clinical sexologist is jaundiced because all I see are people having these problems, but I still believe the number is probably higher. Intimacy skills depend on nuanced and delicate communication between sexual partners. The ability to experience and feel is blunted by psychotropic drugs. Any interest in sex or desire (libido) is invariably muted, or sometimes wiped out, when folks ingest antidepressants.

Physiologically, the side effects are extremely clear. These drugs frequently cause erectile dysfunction in men and difficulty achieving orgasm. In women, antidepressants can cause vaginal dryness and decreased sensation, also making orgasm difficult or impossible. So it’s no surprise that many people (JHHA says up to 90%) stop taking their antidepressant medications prematurely. Fortunately, there are alternatives for restoring sexual pleasure and intimacy that don’t involve ditching medication entirely.

You might try dividing your doses or decreasing your dose very slightly, to see if this eliminates side effects. Of course, you should get your doctor’s advice on any of these suggestions. I’ve found, in my neck of the woods, that psychiatrists are generally better educated about psychotropic drugs than general practitioners.

You could try changing the time of day that you take your pills. For example, if you and your partner usually make love after dinner but before bed, it would be wise to take your medication after sex, but before bed, so the blood levels of the drug will be lowest the next day after dinner (when you usually have sex).

Switching to an antidepressant like Wellbutrin may help, because this type of antidepressant has a lower rate of sexual side effects for most people. Interestingly enough, recent research shows that adding Wellbutrin to your current drug may help as well, as the combination can actually be helpful in decreasing sexual side effects of both antidepressants.

You may be surprised to learn that Viagra can be helpful for BOTH men and women experiencing sexual dysfunction. I must confess that this is not an option that I’ve suggested for any of my patients, but Karen Swartz, MD, at Johns Hopkins, swears by it.

Many people I work with, and their partners, swear by “drug holidays.” Just like a weekend getaway can perk up a tired marriage, not taking your medications for a couple of days can lower the rate of sexual side effects, without increasing the risk of a recurrence of depressive symptoms. These periodic two-day breaks have become something that one couple I work with look forward to, and that anticipation itself can add spice to a relationship languishing in the land of lost libido.

© Copyright 2011 by Jill Denton, LMFT, CSAT, CCS, therapist in Los Osos, California. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 19 comments
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  • Mackenzie

    Mackenzie

    January 22nd, 2011 at 6:00 AM

    What are your thoughts about hormone replacement therapy? Does this typically help those with low libido?

  • Cassie V.

    Cassie V.

    January 22nd, 2011 at 2:56 PM

    A lasting, committed relationship isn’t based on only sex in the first place. Getting depressed over not having a sex drive because of antidepressants is just ironic. Partners need to be more understanding too. Think of it this way, your partner is depressed and the only thing on your mind is sex. Let that marinate for a moment and think about how that makes them feel.

  • Art B

    Art B

    July 13th, 2016 at 7:14 PM

    Cassie: You are not considering all aspects of depression. It, and it alone, can destroy a marriage. Add “no sex” to a depression-rich environment, and it is a guarantee for marriage failure.

  • Helen

    Helen

    January 22nd, 2011 at 5:21 PM

    People make a big deal out of sex to the point where they think the relationship is over if they don’t get any, or have to make up excuses instead of honestly saying “I don’t feel like it”. Reducing your dosage should definitely only be done if your doctor okays it. It isn’t a good idea if you’re depressed and on medication to do so without notifying them of your intent. Remember, it needn’t be a choice between a shoddy sex life due to depression meds, or having your depression lift in exchange for no sex life.

  • Angela

    Angela

    January 22nd, 2011 at 9:18 PM

    Folks, you really do need to talk to your doctor about this kind of thing. Whether your physician considers your sex life important or not can vary quite wildly, so it’s a good idea to get a second opinion on how to approach it best from a sex therapist since they are the specialists.

  • Carol

    Carol

    January 23rd, 2011 at 6:46 AM

    Sex is a huge part of life, like it or not, and a loss of libido can be something that could make you feel like less of a woman. So add all of this to the issues that o=you are already obviously facing because you are on antidepressants and there could be some serious self esteem issues that could come up too. I know that this is not the end all and be all of a good relationship but you have to admit that it is an important one to men and women too.

  • Kayla

    Kayla

    January 23rd, 2011 at 9:26 AM

    If there are antidepressants available that do not cause the problems with sexual issues, like Wellbutrin, then why don’t more doctors prescribe those? I mean, I know that not every mediaction is the right fir for every patient, but it is worth giving something a try first before automatically going for something that is know already to have these harmful side effects.

  • kate m

    kate m

    January 23rd, 2011 at 10:33 AM

    this is one side effect of drugs that we could do without…it can really derail the sexual life of a couple and can lead to many other problems in the relationship…I have seen a friend suffer due to this…

  • samuel

    samuel

    January 23rd, 2011 at 3:17 PM

    It’s possible to be intimate and show love without it being sexual. There’s more ways apart from penetrative sex. Don’t get so hung up on that that you forget there are other options, like cuddling, touching and kissing more. Stay positive! You might discover a new and exciting level of intimacy you hadn’t experienced before through experimentation.

  • jamie

    jamie

    January 23rd, 2011 at 10:56 PM

    a sudden loss in libido is something that nobody would be comfortable about and it can also bring in a gap between partners.so it would be best to talk to your doctor before taking any such meds.

  • ginny c

    ginny c

    January 24th, 2011 at 5:33 AM

    Wonder who suffers the most from a problem like this, men or women?

  • Jill Denton

    Jill Denton

    January 24th, 2011 at 12:06 PM

    Lots of blogging on this my latest-glad to see! As a sex therapist of course I can only speak from my own experience with clients-but two women that I’m currently seeing are on hrt and still having problems.One of you commented that low libido can make you feel “less like a woman”. That’s just the kind of feeling that makes things worse! Really folks, therapy CAN help you to shift those negative beliefs. Also you’ll find that a skilled sex therapist should be able to coach you and your partner toward non-pivi (penis in vagina intercourse) alternatives that can really add to your sexual intimacy together-just like Samuel is talking about (you go Sam!)If any of you have personal questions, please shoot them directly to my email or better yet CALL me at 805-534-1101-I’m much faster getting phone calls returned!

  • Jill Denton

    Jill Denton

    January 24th, 2011 at 12:09 PM

    P.S. Ginny I’ve really found that BOTH genders are effected almost equally. But guys more often will freak out if their erections are off (“My penis isn’t working properly!”)

  • KC

    KC

    January 24th, 2011 at 1:09 PM

    I’ve read on a lot of online forums-A lot of older folks asking the experts what they can do to pep up their sex lives.This is because one partner may experience a loss of libido or because of physical constraints.So I can only imagine how young people would feel when they have a loss in their libido because they are on some drugs.It must be pathetic to say the least.We need all the experts to fore warn the patients about the possible side effects and also a look into developing drugs without these side effects.

  • Faye W

    Faye W

    January 25th, 2011 at 5:46 AM

    What is healthy for one couple may not be what is healthy for another. Don’t compare yourself and your mate to what others are doing and feeling, only think about what works for your relationship. Don’t let the lives of others influence yours. If there is a problem, then you know that there is help available. But do not automatically assume that you should have these issues just because you think that everyone else does.

  • eva

    eva

    January 25th, 2011 at 8:09 PM

    Sex is the foundation of love in a couple, it would be depressing for your partner of course.mostly it will lead to fight!

  • Jill Denton

    Jill Denton

    March 6th, 2011 at 2:22 PM

    I wouldn’t say that sex is the foundation of love for couples – when it’s working it usually comprises only about 15 – 20% of the relationship. When it’s NOT going well it will loom large and create unhappiness more like 80 – 85% of the time! That’s why I added post graduate training in sexology to my years as a marriagte therapist!

  • Elyese

    Elyese

    July 8th, 2011 at 7:45 AM

    I’m on meds for bipolar that weren’t working. When lithium was added I felt much better but my labido is gone. I’m really upset by this, its more than the sex. Its like someone took a whole part of me away, its just gone. My thoughts,feelings,attitude and myself. I’ve lost myself and any med changes are squashed because of the relief I have gotten from the lithium. Do you have any suggestions?

  • beau

    beau

    October 12th, 2016 at 5:38 PM

    I done a lot of extensive research to find a safe, legal, sexual performance enhancing product.And I wanted to make sure it was legal with no weird side effects.
    I am a mature man so sexual performance can sometimes be affected by my age but since using the Dr Max Powers HGH Spray the problem seems to have been eradicated. In the bedroom I feel alot better and my wife also agrees. After taking the correct dosage, the spray takes 30 minutes to work on myself but I guess this varies due to the individual.

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