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Sex Rx: Celexa and Your Sex Life

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Citalopram is widely used in the United States. This medication is FDA approved for treatment of depression . Some doctors may prescribe citalopram to treat other psychiatric conditions also. While Celexa is effective in treating these major depression, it has been associated with sexual problems.

How Citalopram Works

Citalopram is one of a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing the activity of the brain chemical serotonin, which helps regulate mood.

Other Drugs of This Class (SSRIs):

  • Sertraline
  • Paroxetine
  • Fluoxetine
  • Escitalopram
  • Fluvoxamine

Possible Sexual Side Effects Associated with Citalopram

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
  • Erection impairment in men
  • Delayed ejaculation

How This Medication Can Affect Sexual Function

It is not yet clear how SSRIs affect sexual function. The effects are believed to be related to the increased level of serotonin, which may affect sexual reflex centers.

Treatment Options

There are a number of alternative treatment options available if you are dissatisfied with your sexual functioning while taking citalopram. But, it is important to talk with your doctor about your concerns first. Although it can be very difficult and embarrassing to discuss your sexual functioning, it is crucial that you communicate with your doctor about it. Never make any changes to your medication regimen or start taking new medications or herbal supplements without your doctor’s knowledge and approval. Here are some possibilities that you and your doctor may decide to have you try:

Wait It Out

As you adjust to your new medication, the sexual side effects may go away.

Decrease the Dosage

This tactic may work, but carries the risk of a relapse of the depression. Never change your dosage without checking with your doctor first.

Switch Medications

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 medication. When switching is appropriate, some options include:

  • Bupropion—This antidepressant medication 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 major depressive disorder, and seasonal affective 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—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 medication 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 medication you are taking. However, certain options do exist.

Sildenafil and related drugs may be helpful for men with sexual side effects of SSRIs. Bupropion also has been shown to benefit men with sexual dysfunction due to taking SSRIs. Amantadine has been used, but studies have not proven that it is beneficial.

Take a Drug Holiday

This involves taking your usual Thursday morning dose and then nothing again until noon on Sunday, when you resume your previous schedule.

There is a risk with this technique that you may feel well enough during the short drug holiday to discontinue your medication all together, which can lead to a relapse. Also there is a risk of having some withdrawal symptoms from abruptly stopping your medication. Make sure you discuss this option with your doctor before trying it.

Herbal Supplements

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. One herb commonly used to resolve the sexual dysfunction associated with SSRIs is yohimbine. More studies are needed to determine the effectiveness and safety of this remedy. Be sure that you talk to your doctor before taking any herbs or supplements. They could react with medications that you are currently taking.

  • Food and Drug Administration

    http://www.fda.gov

  • Mental Health America

    http://www.nmha.org

  • Canadian Psychiatric Association

    http://www.cpa-apc.org

  • Sex Information and Education Council of Canada

    http://www.sieccan.org

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  • Yohimbe. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated August 22, 2013. Accessed June 5, 2014.