SexRx: Celexa and Your Sex Life
Commonly Used United States Brand Name
What This Medication Is Most Often Prescribed For
How This Medication Works
Citalopram is one of a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medicines work by increasing the activity of the brain chemical serotonin, which helps regulate mood.
Other Drugs of This Class (SSRIs):
Possible Sexual Side Effects
Men or women may experience sexual side effects, such as:
- Decreased sexual desire
- Difficulty with sexual arousal
- Difficulty reaching orgasm or inability to reach orgasm
- Impotence in men
- Delayed ejaculation
How This Medication Can Affect Sexual Function
It is not yet clear how SSRIs affect sexual function. It is believed to be related to the increased levels of serotonin, which may affect sexual reflex centers in the central nervous system. Although some sexual side effects are troublesome for people, others may in fact solve certain sexual problems. For example, men who experience unwanted premature ejaculation prior to starting antidepressant medicine may find that the side effect of delayed ejaculation is actually preferable.
Wait It Out
As you adjust to your new medicine, the sexual side effects may go away.
Decrease the Dosage
This tactic may work, but carries the risk of a relapse of the depression or disorder. Never change your dosage without checking with your doctor first.
Since the medical response to SSRIs can vary among people, your doctor will consider the severity of your depression or disorder, as well as your response to the drug before switching to another medicine. When switching is appropriate, your doctor may have you try:
- Bupropion (Wellbutrin)—This antidepressant medicine does not affect serotonin. It is less likely than the commonly used SSRIs to cause sexual dysfunction, and may actually have prosexual effects. Bupropion is used to treat a number of conditions, such as major depressive disorder, seasonal affective disorder, and depression with bipolar disorder. It is not recommended for people with eating disorders or seizure disorders.
- Nefazodone—This drug does affect serotonin, but not in the same way as SSRIs. It can be used to treat depression and cause fewer sexual side effects. One of its more troublesome adverse effects is sedation.
- Mirtazapine (Remeron)—This drug is similar to nefazodone in its effect on depression and sexual function. It can also cause sedation.
Try an Antidote
This involves maintaining your current level of citalopram, while adding a second medicine to offset the sexual side effects. This option is generally less desirable since antidotes frequently have their own side effects and may adversely interact with the primary medicine you are taking. Drugs that may be used as antidotes are:
- Bupropion (Wellbutrin)—This medicine is not recommended for people with eating disorders or seizure disorders.
- Sildenafil (Viagra)—This medicine is prescribed to treat erectile dysfunction.
- Amantadine (Symmetrel)—This is an antiviral medicine that has also been studied as an antidote for SSRI-related sexual problems. More studies are needed, though to prove that is actually works.
Take a Drug Holiday
This involves taking your usual doses throughout the week, stopping with your Thursday morning dose. You take nothing again until noon on Sunday, when you resume your previous dosage schedule.
There is a risk with this technique that you may feel well enough during the short drug holiday to discontinue your medicine all together, which can lead to a relapse. Also there is a risk of having some withdrawel symtoms from abruptly stopping your medicine. Make sure you discuss this option with your doctor before trying it.
The efficacy of herbal supplements to treat the sexual side effects of SSRIs is not clear. Care should also be taken with herbal products because they are not strictly regulated as drugs are. Be sure that you talk to your doctor before taking any herbs or supplements. They could react with medicines that you are currently taking.
Canadian Psychiatric Association
Sex Information and Education Council of Canada
Amantadine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/healthLibrary/. Updated April 2010. Accessed April 23, 2010.
Bupropion EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 2009. Accessed July 29, 2008.
Citalopram. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated November 30, 2010. Accessed May 9, 2011.
Citalopram. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/drug-information/DR600423. Updated June 23, 2010. Accessed March 31, 2010.
Mirtazapine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed April 23, 2010.
Sex Rx: paxil and your sex life . EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated May 19, 2010. Accessed May 9, 2011.
Sildenafil. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed April 23, 2010.
Last reviewed May 2011 by Brian Randall, MD
Last updated Updated: 5/9/2011
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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