Depression: Recommendations For Sexual Side Effects By Antidepressants

Sexual side effects caused by antidepressants are completely recognized, but this represents a practical problem of managing to physicians. Erectile dysfunction, diminished libido and delayed/attenuated or absent orgasm (dysorgasmia or anorgasmia) are the most common sexual side effects reported because of antidepressant treatment.

However, sexual side effects caused by antidepressants are also a very challenge to clinicians, since they have to distinguish between sexual dysfunction (SD) associated with depression, treatment-emergent SD and pre-existing SD exacerbated by treatment.

Making the difference between these situations is quite important, since treatment strategies are not the same for the above mentioned SDs. Sexual dysfunction associated with depression may be treated raising the antidepressant dose, however, this would be particularly inappropriate for a treatment-emergent SD, in which case the appropriate thing is to lower the dose.

For managing appropriately antidepressant-induced sexual dysfunction, experts recommend that clinicians may attempt to alleviate the sexual side effects of a drug though a reduction of the dose and/or a change to an alternative therapy that may be less likely to cause sexual side effects. These strategies are more likely to be used in patients who are not responding fully to treatment and also risk sacrificing the therapeutic benefit of treatment.

Nonpharmacologic interventions are also recommended by experts. Behavioral and cognitive-behavioral techniques employed by sex therapists are the most common, although there are no studies evaluating their success in patients taking antidepressants.

There exist a number of medications quite useful in the treatment of sexual dysfunction associated with antidepressants. Under experts' opinion, the most common medications for antidepressant-induced sexual dysfunction fall into three categories:

Dopaminergic agents, such as amantadine and pramipexole.

a2-adrenergic receptor antagonists such as yohimbine.

Serotonin 5-HT2 or 5-HT3 receptor antagonists, including granisetron, nefazodone and cyproheptadine.

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Break Free From Depression Helplessness

I recently posted an article to my website about how certain beliefs underpin stress, depression and anxiety. One of the main beliefs I briefly introduced concerns helplessness. Helplessness is a major part of these illnesses so let’s look at how you can reduce the impact this flawed belief has.

Believing you are helpless in life is a truly terrible feeling and I write from personal experience here. For five years, a number of traumatic events led me to the point where I believed life held nothing but pain and anguish. I truly believed life would unfold in a way that would destroy me and there wasn’t a single thing I could do about it.

Perhaps you’ve felt this way too?

The underlying belief is the important factor here. It is a firm belief that life is something that happens to you and you have NO CONTROL over anything. In short, you are a powerless, passive recipient for whatever life decides to throw at you.

It is an awful state to be in. Furthermore, this belief simply isn’t true.

Let me give an example. Say you and your partner split up. Now, this can be one very traumatic experience, I’ve been through it, so have many others. You react in a highly negative and emotionally arousing way:

“I’m devastated. He/she was my whole world and now my world has fallen apart. Everything I do in life always goes wrong and this is another disaster. I’ll never be happy again.”

Wow. It’s a powerful reaction isn’t it? I’m sure you, like me, have either reacted this way to an event or you’ve heard someone react this way. It is a very damaging way to assign a meaning to an event you are confronted with.

The last two sentences reveal the belief in helplessness. The key words are: Everything always goes wrong and never be happy again. When you react in such a way, you are telling yourself that you are helpless because nothing has ever gone right for you and you’ll never be happy no matter what. You’re saying you cannot control anything and therefore, you truly believe you’re helpless.

How do you think you’ll feel when you react like this? Exactly. You’ll feel deeply unhappy, confused, frustrated and of course, helpless to change your life. Why would you feel anything else? Everything ALWAYS goes wrong and you’ll NEVER be happy again so what’s the point of doing anything to create change?

Do you see how helplessness works? But it simply isn’t true. Of course, there are many things in life that are entirely beyond your control. Other people and Mother Nature to name but two. There are things in life you have some control over – where you live and work for example. It is important to keep these facts about control firmly in mind.

Here’s the most important fact about helplessness: There is one thing you have full control over in your life and that is how you react and assign meanings to everything you are confronted with. In the example above, a better reaction would be:

“OK, my relationship hasn’t worked but other things in my life are going well and I’ll concentrate on them for a while as I come to terms with what’s happened. Just because this relationship hasn’t worked out, it doesn’t mean future relationships will fail and once I’ve got over this, I’ll get out there and find someone better.”

See the difference? You’re keeping control by assigning a less emotional meaning, a meaning more in keeping with reality. You’re acknowledging that you’re hurting, but that this is temporary and when you’re ready, you’ll try again. You know you have other things in your life that you can concentrate on and this reaction will prevent a feeling of helplessness arising.

See you soon.

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