Treating Sexual Side Effects of SSRI's

The most common sexual side effect from SSRI’s is delayed orgasm. (more on SSRI’s ) For a lot of men this is not a problem – in fact can be helpful. This effect of SSRI’s is almost immediate – quickest for Effexor, then Lexapro, Celexa, Paxil, Prozac, and Zoloft. Delayed orgasm can be a problem for women – especially if it gets into hours/days (kidding on days). But absent orgasm is a problem for both.
A previous study showed that short acting Wellbutrin taken 1-2 hours before sex would correct orgasm problems in 40-45%. If Wellbutrin were taken regularly, another 20% or so would respond. If it works on a PRN (as needed) basis, why use it daily? Well, if you’re having sex very frequently, daily medication makes sense. If once a week, PRN makes more sense. Other things that have been used for anorgasmia include stimulants, Yocan (OTC or prescription), and Amantadine. Viagra, Cialis, and Levitra have also been helpful for some (probably by increasing degree of stimulation).
For treating problems with arousal in men, Viagra, Cialis, and Levitra have been effective for most – here PRN is the rule. Sometimes trazodone helps PRN for erectile dysfunction through its alpha blocking effect – since norepinephrine decreases arousal (a frequent problem with decongestants and sometimes stimulants).
Treating loss of libido requires daily treatment. Sometimes Wellbutrin or a stimulant can be helpful.