How can I reach orgasm on Zoloft?

October 9, 2004 6:15 PM

Zoloft and sexual side effects, specifically the amelioration thereof. [Too much information inside.]

(I long for the old login/login. Oh well.)

So, about six weeks ago, I began taking Zoloft to treat depression and social anxiety. It is going splendidly. So splendidly in fact, that I have a nascent relationship with a girl I'm really quite fond of, which would have been inconcievable to me prior to taking the happy pills.

The complication is that Zoloft has this tendency to inhibit orgasm. While I find the heroic endurance I am now capable of to be kind of interesting, I'd be a lot happier if orgasm were easier to achieve. In the next week, I have my third appointment with the mental health practioner who prescribed the drug and I'll be discussing this with her. What I would like is any sort of anecdotal techniques used by the Metafilter community to address the issue. The anecdotes and experiences I recieve here will be the basis for question that I ask when I see the doctor next. Thus, responses beginning with "my friend's friend had a cousin that..." are perfectly acceptable as everything will be verified by a professional before I move forward.

The woman I'm dating mentioned that gingko biloba might have beneficial effects, but to say that Googling for herbal supplements does not yield useful results is the understatement of the Internet age. At my next appointment, I plan to ask about sexual side effect-free Wellbutrin, but that drug doesn't look like the best way to treat my symptoms.

What I've done so far is to try my best to relax about it and to pretty much give up my own "personal time." I'm hoping somebody here has found a better solution.

Pertinent information is that I'm male, in my late twenties, a light-to-moderate smoker, and in decent (skinny but not inclined toward massive aerobic exercise beyond the occasional backcountry ski trip or hike) shape. I'd rather f*ck up my sex life than give up the pills. I feel like a human being for the first time in years and a little weirdness in the sack is a small price to pay, but I'd rather not pay it if it can be avoided.

Help? And thanks in advance.

posted by stet to health (20 comments total)

My experience was not with that medication in particular, but with a similar popular one; not Wellbutrin, either. I experienced similar side effects, although I suspect either to a lesser degree or I found myself less disturbed by them. It had no effect whatsoever on my libido -- if anything, it increased -- but I found orgasm took somewhat more focus and effort to achieve. I really had to strain for something that was formerly very easy.

I, too, found this to be interesting. In fact, I found the long build-up combined with the additional physical effort and concentration led to a "larger," more satisfying orgasm. I'd consider the sex I had on happy pills -- brief that my pill experience was -- to be pretty damn good.

Perhaps I wasn't affected quite so strongly, or perhaps your drugs are simply different from what I took, but I was able to embrace and enjoy the different character that sex had.
posted by majick at 6:42 PM on October 9, 2004

First of all, I would give your body maybe one or two more months to see if it adjusts to Zoloft's side effects. Sometimes it just takes longer. You may also want to ask your doctor about Lexapro, which is a similar SSRI that is supposed to be better with such things. On the other hand, if Zoloft is working great, it might not be such a good idea to change it. I have heard that taking a small dose of Wellbutrin in addition to Zoloft might help, but I have no first hand experience with this. To be honest, I dont think there is much you can do about the side effects without changing the drug/adding some other drug.
posted by TheIrreverend at 6:45 PM on October 9, 2004

I would look into Celexa a fairly tame SSRI, or it's reverse molecule Lexapro (didn't work for me, but I'm apparently special).

And give up the smoking, man!
posted by ParisParamus at 6:57 PM on October 9, 2004

Orgasm is overrated, anyway...
posted by ParisParamus at 7:00 PM on October 9, 2004

Oh, and since you're taking "friend of a friend of a friend" information: I met a woman on the bus a few years ago who said she was taking Wellbutrin as part of her smoking cessation program, and she claimed it made her extremely horny all the time.
posted by majick at 7:04 PM on October 9, 2004

See if your doc will add some wellbutrin to the mix. It does have aphrodisiacal properties, and you can indeed take it with zoloft.

Actually, it is true that the sexual side effects can wear off some after awhile.

Also, I understand that there are creams and such that your doctor can prescribe that can help. There are also herbal creams that I understand can be obtained without a prescription. Talk to your doctor-there are options.

Full disclosure: I am not male, but I have taken both zoloft and wellbutrin in the past.
posted by konolia at 7:09 PM on October 9, 2004

"YOMV"
posted by ParisParamus at 7:32 PM on October 9, 2004

This is the side effect (oh and chronic nausea) that made me go without anti-depressants for the past two and a half years.
posted by frenetic at 8:21 PM on October 9, 2004

have you felt any detachment from the situation as opposed to uh, the plumbing not cooperating? I had to go through a host of anti-depressants/SSRIs before I found the right mix. Some provided an almost professional detachment from the situation, some made sure nothing happened, and by the end I found the right mix of sanity and sexuality.
you bring up a terrific point many don't realize - for the first time in far too long, the fog has lifted. You might be not be realizing what you would have been thinking/doing had you not started the medication(s). For me, I was walking down the street before I realized my OCD hadn't kicked in to force me to decide which foot should step off the curb first. Sure, you are in the midst of this great relationship but you are also seeing things differently overall.
So you might have to take some combination of drugs to make this work, or your body might adapt. Absolute candor with your Doctor is a must, and with your partner as well. Some partners see this as too challenging and some see it as a wonderful challenge. I found this a great time to learn all I could about alternative ways of pleasure with a partner and it has paid oustanding dividends.
posted by TomSophieIvy at 9:42 PM on October 9, 2004

Viagra. No joke...
posted by gokart4xmas at 10:58 PM on October 9, 2004

a) Commenting as a board-certified neurologist; information here is general in nature, not to be considered specific for any given patient; consult your own doctor for individual recommendations.

b) Consult your prescribing doctor about this side effect. It is extremely common and he/she will be used to dealing with it.

c) Acclimatization to the med, if one is not increasing the dose, happens in about 6 weeks maximum. If side effects are still present after that they are likely going to be present while one takes the med for the foreseeable.

d) My friend on zoloft said "the numb dick wore off in about a month." Caveats: anecdotal evidence, etc.

e) All the antidepressants can cause this - it's quite common with wellbutrin too, dunno how one might get the idea it's not. Anorgasmia, which you describe, is different from erectile dysfunction; Viagra can 'band-aid' erectile dysfunction, but there is no simple band-aid for anorgasmia short of going off the med. Lots of separate systems have to operate in synchrony to deliver a successful male orgasm.

f) If a hypothetical person wanted to mess around with what one admits already is a good thing going, here is the order in which I'd try different meds: effexor, paxil, prozac, luvox, celexa, lexapro, wellbutrin, nefazodone, amitryptaline. All will have side effects. You may not want to mess. Sertraline's a great drug - as you've discovered, it works.

g) I replaced 'you' in this post with 'one' or 'a hypothetical person' because I don't want this to be misconstrued as individual advice to you or anyone else - I can't do that over the internet! See your doctor!
posted by ikkyu2 at 10:59 PM on October 9, 2004 [1 favorite]

Stay off effexor! It is an absolute bitch to wean off off, and I do mean absolute! Lots of other things to try that are much easier.

And I have to say again that wellbutrin is one drug that for me and everyone else i know who takes it, does NOT mess up one's sex life. It acts on a different neurotransmitter.
posted by konolia at 4:29 AM on October 10, 2004

Although you said you think Wellbutrin might not be right for you, switching from Lexapro to Wellbutrin did the trick for me.

Now if only someone else other than me were around to notice...
posted by emelenjr at 9:03 AM on October 10, 2004

Quit smoking. Nicotine is a vasoconstrictor, and those blood vessels need to be DILATED, eh?
posted by LimePi at 11:12 AM on October 10, 2004

Quit smoking. Nicotine is a vasoconstrictor, and those blood vessels need to be DILATED, eh?

Hello? He said he's capable of heroic endurance, which means erections are not a problem. Anorgasmia has nothing to do with vasodilation.
posted by ikkyu2 at 12:50 PM on October 10, 2004

I agree with gokart4xmas. I'm not sure why, but viagra can make the final destination easier to get to. (anecdotally of course) And also, that side effect does decrease with time, or you get used to it, or less worried about it. For some people, getting used the new lower tolerence for alcohol is also a factor, I know someone who gets quite drunk off 2 beers on prozac.
posted by milovoo at 1:26 PM on October 10, 2004

Thanks much all. I've got more than enough here to talk to my doctor and hopefully find a solution. I truly appreciate all your help.
posted by stet at 4:15 PM on October 10, 2004

Lexapro does the same thing (and to be honest, I don't mind this side effect at all). However, the side effects (along with lack of appetite) have mostly faded after about two and a half months.

Give it time, things will slowly "go back to normal" as you get used to the medication.
posted by mrbill at 5:51 PM on October 10, 2004

Dear Penthouse Forums...

I met a woman on the bus a few years ago who said she was taking Wellbutrin as part of her smoking cessation program, and she claimed it made her extremely horny all the time.

... sorry, couldn't resist...
posted by mkultra at 11:23 AM on October 11, 2004

A fairly hefty dose of Gingko, which you can find in any health food and vitamin store, will make a significant improvement. It won't eliminate it, but it undeniably has a posotive effect.
By hefty, I mean in the neighborhood od 1.5 to 2 times the usual daily dosage.
Aside from thinning your blood a bit, gingko is relatively harmless. You might notice easier bruising etc if you take other blood thinners with it buf if you don't, its not likely to be a prob for you.
Also: if and when you go off the SSRI, be prepared for an equal and opposite effect for a few weeks. Teel em to call you "speedy". Again, this goes away by itself after a few weeks.
For those who take it for long periods of time desite this side effect, be prepared for a significant chance that things won't ever wuite be the same again. The net is full of anecdotal info in this regard. (The SSRI mfrs still insist that sexual side effects happen to no more than 10% of people taking their products, while everyone dispensing the prob syas its more like 75-80%, so don't expect the mfr to be helpful about this. Its the number one cause of people dropping out of SSRI treatment...)
posted by Fupped Duck at 1:09 PM on October 11, 2004