The great amount of Prozac-type medications available at the drug store provide secure and effective relief from depression - but frequently at the cost of a patient’s sexual desire or ability to achieve orgasm. Currently, there is a new medication that bypasses such problems.
According to a report in the March issue of the Journal of Clinical Psychiatry, an alternative antidepressant medication- Wellbutrin - counteracts the sex problems resulting from medicines like Prozac, Paxil, and Zoloft.
"When a patient is on an antidepressant drug, s/he may also experience several side effects of sexual dysfunction," WebMD was tolb by the study author Anita H. Clayton, MD. "In our latest research we are analysing Wellbutrin as an antidote that you can add in."
Prozac and similar medications act by increasing levels of a brain chemical substance called serotonin - they are known as SSRIs, which stands for selective serotonin reuptake inhibitors. This can be an enormous benefit to some people suffering from depression. However, about half of the men and women taking these medications observe that it affects their sexual desire and performance. The majority of these patients report a decline in sexual desire, and others report that the medication makes it difficult for them to reach orgasm while having sex.
"A considerable number of people regard this as a major side effect that completely discourages them from staying on - or starting - an antidepressant medications," Jeffrey E. Kelsey, MD, PhD, tells WebMD. Kelsey, director of the mood and anxiety disorders clinical trial program at Emory University in Atlanta, was not engaged with the Clayton research.
Wellbutrin fights depression by working on a different brain chemical than the SSRIs. Therefore, Clayton and her assistants at the University of Virginia in Charlottesville decided to examine whether switching to this medications would help people with SSRI-related sex problems.
Despite the fact that patients reported sex problems, very few of them were willing to risk giving up the SSRIs that successfully relieved their depression. However, the scientists managed to find eight women and three men who were willing to try it out. Within the first two weeks they took Wellbutrin apart from their SSRIs (four were taking Paxil, four were taking Zoloft, two were taking Prozac, and one was taking Effexor).
In the course of these two weeks, most patients’ sexual function started to get better again. Within the next two weeks, the patients started to give up steadily their SSRIs, and within the last two weeks of the research the patients took Wellbutrin alone. Several patients had a problem with this, and only six patients completed the whole research. But these six patients were easily able to keep their depression under control and their sexual function improved.
"There are all sorts of [brain chemical substances] affecting the sexual function," Clayton claims. "With SSRIs you force the serotonin system to become more active. It usually leads to problems with the ability to achieve orgasm, but it also decreases the desire. This research revealed a lot of general improvement, but also improvement in desire due to the fact that Wellbutrin acts [on different brain chemicals] linked to all sorts of things - including desire."
In later research - which will be reported by Clayton at the American Psychiatric Association meeting in May - the scientists simply gave Wellbutrin to patients with sex problems connected with their SSRIs. It seems to be effective, although several patients need to have their medication dosages tailored.
And with a longer taper-off period, a lot of patients were able to switch to Wellbutrin.
"In our latest research we carried on both medications over one month," Clayton claims. At each point in time the patients got better and better in every measure. Wellbutrin was able to control their depression - and their sexual functioning improved."
Kelsey explains that when a patient who is doing well on SSRIs complains of certain sexual problems, psychiatrists first try to decrease the dose of the medications. If this doesn’t bring any positive result, they may try switching to another SSRI. And if the patient still does not get better, he says, a lot of physicians try to add Wellbutrin to the medication that the patient is on.
