Does sexual response ever come back when on Lexapro?

November 29, 2004 12:12 PM

One month into a three month trial of Lexapro, which is supposedly the mildest of the SSRIs (WRT side effects) currently on the market, and I'm left with a burning question for other women who have been here, done this: do the orgasms really come back?
posted by anonymous to health & fitness (33 comments total)

semi-tangent: because I switched from Celexa to Lexapro, (~mirror image molecules)(only to find the latter had ZERO efficacy for me), I researched this issue, and from what I read, it's not clear the Lexapro has any less side-effects than Celexa. So, if your "complaint" does not abate, perhaps try Celexa--who knows what quirks your physiology may have...
posted by ParisParamus at 12:31 PM on November 29, 2004

I've never been on Lexapro or any other SSRI (other than a very brief stint on Zoloft that was notable chiefly for making me feel like I wanted to put my head through a window), so I'm afraid I can't help you there -- but I have been on Serzone (a non-SSRI antidepressant) for several years and had no side effects in that department. (Very few side effects overall, in fact.) So that might be worth considering down the road, if you find the Lexapro continues to be bothersome. Good luck.
posted by scody at 12:36 PM on November 29, 2004

Of course. . .but you may need to stop taking the medication to allow that to happen. Everyone has a range of experiences on all the different drugs, but I've heard, and also experienced first hand, that Wellbutrin may have the opposite effect of the traditional SSRIs in that regard - easier to attain and stronger orgasms. You'll have to keep talking to your doctor, and don't give up - it's important.
posted by rainbaby at 12:41 PM on November 29, 2004

Wellbutrin may have the opposite effect of the traditional SSRIs in that regard - easier to attain and stronger orgasms. You'll have to keep talking to your doctor, and don't give up - it's important.

The co-worker of mine (who is FAR too open about her sex life) would agree with this statement. She switched to Wellbutrin and she said they started coming fast and furious.
posted by grum@work at 12:58 PM on November 29, 2004

There is actually some research that says you can take brief drug holidays-like not take them on weekends, for example, to get the orgasms back. When I was on zoloft., that particular side effect eventually went away-but that might have been because it pooped out on me with the antidepressant effect as well.

Wellbutrin, on the other hand, is practically an aphrodisiac as far as I am concerned. Really.
posted by konolia at 1:00 PM on November 29, 2004

An earlier question with many good answers, albeit dealing with a similar problem from the male perspective.
posted by stet at 1:04 PM on November 29, 2004

funny timing anonymous. . . i was thinking of posting a question about quitting SSRIs today; i'm on paxil, and am trying to quit in part because i've been virtually libido-less for nearly three years now. i tried the paxil/wellbutrin cocktail so many people recommend, and it did nothing at all for me. while i have no experience with your particular SSRI, i'm afraid that the orgasms did not come back for me (at least, not with any regularity); however, paxil is notorious for this side effect.

i would urge you to give it time, and don't give up. the positive aspects of SSRIs can be very powerful. if this side effect continues, don't be shy about talking to your doctor about it -- s/he should be able to help you find a solution.

on preview: konolia's comment is interesting. an ex of mine used to do this with his SSRI med on weekends and it helped a bit, but i would hesitate to meddle with your prescription like that, especially since you've only been taking it for a month. SSRIs need a while to work properly.
posted by katie at 1:16 PM on November 29, 2004

Effexor hasn't had any negative effects on my sexual response.
posted by Sidhedevil at 1:20 PM on November 29, 2004

In my experience the sexual side effects of SSRIs almost never resolve while you're on the medication. Usually it's the sleep issues and gastrointestinal stuff that resolves after the first few weeks of use. Of course some people never get these side effects, and others have had success with drug holidays.

For those that can't tolerate the sexual side effects, step one is usually switching to another ssri. This also almost never works. The next step is Wellbutrin, Effexor, Serzone or other non-SSRI antidepressants.
posted by drpynchon at 1:28 PM on November 29, 2004

Despite explicitly informing the doctor that I didn't want to be put on pills, he handed me seven weeks worth of free samples of Celexa and rushed me out the door. I let them sit in the cupboard for a few weeks until I fell into a deep enough funk that I lost some of my resistence.

I only tried them for three or four weeks, but I found their tendency to negate a good chunk of sex drive was the only thing I liked about taking them, being that having no outlet for such urges may be what makes me a miserable little shit. I found it a relief, at least for a couple weeks.

But I could see how others might not welcome being neutered.
posted by TimTypeZed at 1:29 PM on November 29, 2004

Wellbutrin may have the opposite effect of the traditional SSRIs in that regard

Ugh, that may be just for girls, because I have know males for which taking Wellbutrin utterly killed their sex lives, along with making them feel very foggy, uncreative, metally stifled. THe ones I knew well were taking it to deal with seasonal affective disorder though, and have since found less drug-based solutions (more exercise, special lights, etc).

It might have something to do with gender, what it's treating, or it may just be the individual. Don't count on a drug to have the same effects on everyone.
posted by nelleish at 1:34 PM on November 29, 2004

From the male point of view - yes, but it takes a couple of months. I've been on it for three months now, and all the side effects gradually went away.
posted by mrbill at 1:42 PM on November 29, 2004

The SSRIs are notorious for sexual side effects, as many have mentioned. TimTypeZed makes a point that has been too little acknowledged, which is that some of the efficacy of these meds may well be due to blunting desire. Sexual desire specifically, but also other desires. Weaker desire=less reason to be depressed.

Wellbutrin is what we prescribe in clinic (I'm a psychotherapist) for pt's wanting to avoid sexual side effects. Stopping any SSRI should be done with care, and with a nice taper. Psychotherapy is just as efficacious (see the recent review in Consumer Reports) and has no side effects. It's cheaper in the long run as well, since relief lasts after the therapy ends.
posted by OmieWise at 1:43 PM on November 29, 2004

I'm on Celexa, and I find pot takes care of the anorgasm side of things. If you're living in the USA, that might not be much of an option.
posted by five fresh fish at 1:58 PM on November 29, 2004

Omie, that's a pretty irresponsible remark. Psychotherapy is NOT, across-the-board, a substitute for medicine; it depends on the source/origin of one's depression.

And for boys who may be considering an SSRI (it took me years before I took the plunge), they are amazing things. And, sexually, they have actually improved things, because they slow "things" down. But, YOMV
posted by ParisParamus at 2:21 PM on November 29, 2004

I was on Lexapro for about 1.5 years. At the beginning, it took me a good month to overcome the anorgasmia thing, though it didn't kill my sexual desire, which was a bigger fear for me. (My doctor gave me a prescription only after I made him promise, on pain of death, that teh Lex wouldn't mess with teh sex.) In fact, it kind of enhanced my desire, simply because I was no longer in the bell jar.

But the good thing was that after that first month or so, the orgasms came back. It took longer at first (an issue that a male friend who was also on Lex termed "the 45 minute problem") but eventually it was all back to normal. YMMV, of course.

TMI ALERT!

An interesting sidenote: I went off Lexapro a couple months ago, and now I've discovered that I'm multiorgasmic. Same partner and same...practices. I have no idea if it's from months and months of learning to concentrate harder on achieving it or what, but Katy bar the freakin' door, man.
posted by cowboy_sally at 3:23 PM on November 29, 2004

I've never taken Lexapro, so YMMV, but with Paxil they did come back.
posted by sugarfish at 3:24 PM on November 29, 2004

I am currently on Lexapro (as my psychiatrist explained it...Celexa contains two separate isomers. Lexapro contains only one of the isomers of Celexa -- incidentally the one believed to be most effective and without the horrible side effects).

I started on Paxil and went through a wicked withdrawal when I tried to ween myself from anti-depressants. About 8 months later when the panic attacks came back...I was placed on Celexa. Then my metabolism grinded to a halt and I gained 30-40 lbs in about a year.

So, to avoid this fantastic side effect...Prozac. The benefits of the half-life of Prozac is that you don't feel like banging your head into the wall if you forget to take it but my anxiety came back in full force. So, now Lexapro.

Despite my complete pharmacological history...the point is that I am feeling your pain. Didn't have the problem on Paxil...had the problem on Celexa, Prozac and Lexapro.

It can be maddening. Do you have the "almost there" issue? I am anxiety free...forty lbs over weight without the benefits of orgasms!

God, I wish this were anonymous...then again my life...open book.
posted by Lola_G at 3:30 PM on November 29, 2004

I don't know about lexapro, but my dad has been on various doses of prozac and other ssri's for awhile now (approx. 10 years, I think), and he occasionally takes a night off for one reason or another without much harm. Talk to your doctor first, of course.
posted by muddgirl at 4:31 PM on November 29, 2004

I don't really understand this "drug holiday" thing: the half-life of the most popular SSRIs is fairly long; with prozac, you would likely need a few days to even notice any effect; almost as long with Celexa/Lexapro.
posted by ParisParamus at 6:15 PM on November 29, 2004

Zoloft, one day off per week. The diminished libido seems to be balanced out by greater overall willingness. The orgasms, they never went away.
posted by whatnot at 7:14 PM on November 29, 2004

I don't know how it's supposed to affect males, but I haven't noticed a huge difference sexually after starting on Lexapro (1.5 yrs now). I did get some strange headaches/light-headedness when I went off for a few weeks though... that kind of scared me.
posted by still at 7:22 PM on November 29, 2004

I know someone who had to quit taking Lexapro due to the lack of sexual desire and the inability to achieve orgasm. I have known people who say they never lost the ability. I think it all depends on the person. If it's bothering you, talk to your doctor that prescribed them about it.
posted by Nenna at 7:44 PM on November 29, 2004

When I was on Prozac or Zoloft, no sex drive, nothing. They later switched me to a combination of Celexa and Wellbutrin (not for side-effects reasons, but because the Prozac, Zoloft, or Celexa by itself weren't working). On that combination, I had a sex drive, but it was like everything was anesthetized. Literally almost like there was Novocaine...down there. "The 45-minute problem", indeed. (I kept wondering if chafing was going to be a problem.)
posted by Vidiot at 8:26 PM on November 29, 2004

I'm on effexor and wellbutrin, and it's nigh impossible for me without calling in heavy machinery (i.e. nothing battery powered will do, mine plugs into the wall). Scared shitless of any med changes, however. They tend to make me very suicidal-feeling (but luckily not acting) real real quick.
posted by beth at 9:21 PM on November 29, 2004

Celexa contains two separate isomers. Lexapro contains only one of the isomers of Celexa

Thank you! I'll didn't know, and I'll be asking about it next time I'm at the doctor's.
posted by five fresh fish at 11:29 PM on November 29, 2004

I know many people who have taken may different SSRIs, male and female, including myself. It's fair to say that just about every SSRI will effect orgasms, but I've not known anyone who has had symptoms that stay too much past the rest of the withdrawl side effects.

On the subject of drug holidays, be VERY careful. Effexor (for example) has a half life of just four hours. After five half lives (20 hours) you have none of the drug left in your system. That's why effexor has to be taken twice daily or in XR format. If you miss it for a day then you could potentially be hit with all your withdrawl symptoms followed by hard reuptake symptoms if you then hit your body with a full dose the next day.

Admittedly I got no uptake or withdrawl symptoms from my brief time on Effexor, but is it worth the risk?
posted by twine42 at 3:36 AM on November 30, 2004

Apparently, I am from another planet, because the isomer missing in Lexapro is the one I need!
posted by ParisParamus at 3:50 AM on November 30, 2004

Apparently, I am from another planet, because the isomer missing in Lexapro is the one I need!

Or I am? Who knows? I guess it depends on what ails you. My primary issue is anxiety/panic attacks with mild OCD -- "Did I lock my front door" Check five times...

Life ain't it grand?
posted by Lola_G at 7:17 AM on November 30, 2004

Paris wrote:

Omie, that's a pretty irresponsible remark. Psychotherapy is NOT, across-the-board, a substitute for medicine; it depends on the source/origin of one's depression.

In a thread about the side-effects of anti-depressants, it seems strange to assert that suggesting psychotherapy, which has no side-effects, is irresponsible. What we know about mental illness is not a lot, and despite what your psychiatrist tells you, we have no evidence that it is caused by biological changes in the brain. In fact, there is plenty of evidence to the contrary.

We also know that psychotherapy is an effective treatment for most forms of mental illness. It is true that there is no advertising budget for therapy, but that does not mean that it does not work. And there are no black box warnings on psychotherapy (although there are wacky and irresponsible practitioners who take advantage of and harm people). This is not to suggest that medications do not work. They clearly have effects, as this thread testifies, and they are very useful for some people. But it is irresponsible to suggest that psychotherapy is not a viable option for the treatment of depression.
posted by OmieWise at 8:30 AM on November 30, 2004

OmieWise: A nit-pick because mostly I don't disagree with you but I wouldn't say that psychotherapy has no side-effects. If you think that therapy done well can be helpful then it'd be difficult to hold that bad therapy can't do damage. I believe that I was hurt by incompetent therapists in my late teens.
posted by TimeFactor at 10:39 AM on November 30, 2004

For example, because of the damage I don't not like not using non-negatives.
posted by TimeFactor at 10:41 AM on November 30, 2004

FWIW, there was a period where I thought Celexa had ruined my vie lit-eraire. Then, my short marriage ended, and I realised there was no cause and effect...
posted by ParisParamus at 2:47 PM on November 30, 2004