Have Antidepressants Lowered Your Sex Drive?

by JR Thorpe

Out of all of the side effects of antidepressants, which is the one that users complain about most often? The answer is low libido — which sucks. For many people suffering from depression, it can seem like the price of a decent mood is never wanting to get dirty ever again. But there are increasingly more options for women stuck in this particular sticky situation. The downside? None of the possibilities are entirely without other risks or side effects.

Unfortunately, we can't just pop a pill prescribed for low libido, combine it with our antidepressants, and — bingo! — have a raging sex life and no weeping fits in the bathroom at work. Negative drug interactions stand in the way of that particular vision. In fact, the pill Estratest, which is sometimes prescribed for low libido in women, isn't actually allowed to be used in combination with any antidepressants — not even St. John's wort, the herbal supplement used to improve mood — because the ingredients interact so poorly.

However, when doctors are analyzing how to cope with a depressive's busted sex drive, there are a few medications and herbal options that often come up. Here are five of the most popular options — but they all come with their own difficulties, so don't just go out and order a bunch online. Consult your doctor and mental health professional before you do anything with your meds.

1. Wellbutrin

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How It Works

This is normally the first port of call if you show up at a doctor's office with an antidepressant prescription and a libido lower than an ocean chasm. Wellbutrin, or bupropion, is an antidepressant in and of itself — it's what's called an "atypical" type, which means it's not an SSRI or a tricyclic antidepressant — but it's also sometimes prescribed alongside other antidepressants, in order to reduce their side effects. And it's not just helpful for reversing your sex drive's nose-dive — Wellbutrin is also famous for not inducing sleeplessness or weight gain, two other common antidepressant side effects.

What Are The Risks?

Wellbutrin is a fantastic drug, but it comes with a very nasty side effect: an increased risk of epileptic seizures. This isn't unknown in antidepressant history — many of the very old school, serious antidepressants like monoamines tended to lower your convulsive threshold, too — but modern SSRIs have mostly weeded that problem out. The risk created by taking Wellbutrin is still quite small: in patients taking the maximum dose over a two-year period, the risk of seizures was 0.48 percent. But for some people, particularly those who have a low seizure threshold already (if they've got epilepsy in their family, for instance), Wellbutrin is not a fun option. At all.

2. Testosterone

How It Works

The link between antidepressants and lowered sexual desire may actually be caused by a lack of the male sex hormone testosterone, but the science isn't totally clear. It seems that people taking antidepressants do often suffer also from low testosterone at the same time — but that may be caused by the depression itself, not the pills.

But testosterone is being promoted as a potential addition to antidepressant prescriptions anyway — because, according to a 2015 study, it helps the drugs work better in the brain. And testosterone is a libido-booster for women — so for some, this may be a miracle cure.

What Are The Risks?

We don't know what impact the long-term use of testosterone may have on your health, whether it is taken in conjunction with antidepressants or without. It's one of those options that hasn't yet been cleared by clinical trials, and therefore your doctor may not be keen to give it to you, just because the risks aren't fully known.

3. ArginMax

How It Works

Herbal medicine to help your libido? Yes, really. ArginMax is a herbal supplement created from a combination of gingko bilbo, ginseng, passion flower and a bunch of other vitamins and additives, and is designed to increase blood flow and muscle relaxation, helping create a libido spike. It's different from other herbal medicines in that a full-blown clinical trial (double-blind, with placebos) found that it did in fact provide a small boost in libido levels for both men and women.

What Are The Risks?

ArginMax doesn't interact well with a bunch of things: it can't be used if you take blood thinners, or have diabetes or asthma. The ginseng element also means that you can't take it you're on a monoamine oxidase inhibitor (MAOI) antidepressant, because they interact badly. And there hasn't been a full-scale clinical trial on its interaction with antidepressants of any kind over a long period. At the moment, the clinical advice is not to take ArginMax and antidepressants together until more research is done, though your doctor may have other ideas. So make sure to consult with them before you take this (or anything else).

4. St. John's Wort

How It Works

If you want to take St. John's Wort, a herb whose affects on depression have been known for centuries, you'll have to drop your other meds, as it interacts badly with clinical antidepressants (so make sure to consult with a doctor if you're considering it). The chemicals hyperforin and hypericin seem to be responsible for its mood-boosting affects — and the herb isn't believed by scientists to impact your sex drive, probably because it's mild in effect.

What Are The Risks?

If taken in large doses, St John's wort could make you incredibly sensitive to sun exposure. It's also of no use if you suffer from major or chronic depression: it's only going to work for mild or moderate sufferers. It can also cause hypomania, a rapid see-saw from low to high mood and back again, as well as dry mouth and nausea. It can also interact poorly with birth control pills, making them less effective.

5. Zestra

How It Works

Zestra is another over-the-counter option — a combination of essential oils designed to create more arousal in women when applied directly to the genitals. And it's been subject to a small clinical trial which found that it improved "level of desire, level of arousal, satisfaction with arousal, genital sensation, ability to have orgasms, and sexual pleasure". Pretty rad. Plus, the scientists were kind enough to check whether it had any interaction with antidepressants, and it looks like the answer is no.

What Are The Risks?

The test was tiny — only 20 women were involved — and we'll need more testing to see exactly what its use might be, long-term. And the study also showed that there was one unpleasant side affect in three out of the twenty women: a mild burning sensation down yonder. It's always something, huh?

Images: Alejandra Quiroz/ Unsplash, Arginmax, Getty (2), Giphy (3)