How can I improve my libido while taking an antidepressant?

A fairly high number of individuals who take anti depressant medications complain that they have decreased libido, lack of sexual desire, failure to achieve an erection or inability to ejaculate. The exact numbers of people who have sexual dysfunction from anti depressant medications is not known, but anecdotal reports suggest that the numbers are high.

The sexual dysfunction that occurs with anti depressants has been known for decades and is somewhat difficult to resolve. Almost every class of anti depressant drugs has been associated with sexual dysfunction and lowered sexual excitement. The sexual dysfunction generally occurs after the patient has been on the drug for a few months. In some cases, the sexual dysfunction improves with time, but in many cases, the problem only gets worse. These sexual side effects while not life threatening, seriously affect an individual’s lifestyle. Often the patients solve the problem by refusing to take their medication. This lack of compliance then leads to worsening of the mental health problem.

So how can this problem be resolved?

When an individual first complains of sexual dysfunction, a wait and see approach may be appropriate because some individuals will improve with time. The wait and see period should not be more than 2-4 months. If the patient has not improved by then, he/she is unlikely to improve.

Pristiq- a newer antidepressant

Recently the FDA approved a new anti depressant called Pristiq. Known as desvenlafaxine, it has been in use for about 10 months. It works like the other anti depressant medications and brings back the balance of certain neurotransmitters in the brain. Pristiq is quite long acting and is taken once a day. Just like the earlier generation of anti depressants, it also has a few side effects that include:

Nausea
Lightheaded
Excess sweating
Constipation
Generalized tiredness
Diminished appetite
Anxiety, apprehension
Decrease libido in men

While Pristiq does not cure depression, it remains an option for individuals who do not respond to the older anti depressants. The other advantage of Pristiq is that it has been shown to be an excellent drug for treatment of melancholia that occurs during menopause.

From recent clinical trials, it has been shown that about 70% of individual with major depression do respond to Pristiq. Further, the trials also showed that remission rates for Pristiq were much lower than the older anti depressants. Whether the drug works for chronic depression has not been fully evaluated.