Celexa
Citalopram is one of a class of drugs called selective serotonin reuptake inhibitors (SSRIs). These medicines work by increasing the activity of the brain chemical serotonin, which helps regulate mood.
Men or women may experience sexual side effects, such as:
It is not yet clear how SSRIs affect sexual function. It is believed to be related to the increased levels of serotonin, which may affect sexual reflex centers in the central nervous system. Research shows that the sexual side effects are often dose-related.
Although some sexual side effects are troublesome for people, others may in fact solve certain sexual problems. For example, men who experience unwanted premature ejaculation prior to starting antidepressant medicine may find that the side effect of delayed ejaculation is actually preferable.
As you adjust to your new medicine, the sexual side effects may go away.
This tactic will work occasionally, but carries the risk of a relapse of the depression or disorder. Never change your dosage without checking with your doctor first.
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 medicine. When switching is appropriate, your doctor may have you try:
This involves maintaining your current level of citalopram, while adding a second medicine 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 medicine you are taking. Drugs that may be used as antidotes are:
This involves taking your usual doses throughout the week, stopping with your Thursday morning dose. You take nothing again until noon on Sunday, when you resume your previous dosage schedule.
There is a risk with this technique that you may feel well enough during the short drug holiday to discontinue your medicine all together, which can lead to a relapse. Also there is a risk of having some withdrawel symtoms from abruptly stopping your medicine. Make sure you discuss this option with your doctor before trying it.
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 these remedies. Be sure that you talk to your doctor before taking any herbs or supplements. They could react with medicines that you are currently taking.
CANADIAN RESOURCES:
Canadian Psychiatric Association
http://www.cpa-apc.org/
Sex Information and Education Council of Canada
http://www.sieccan.org/
References:
Amantadine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 2010. Accessed April 23, 2010.
Bupropion EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated December 2009. Accessed July 29, 2008.
Citalopram. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/drug-information/DR600423. Updated June 23, 2010. Accessed March 31, 2010.
Mirtazapine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed April 23, 2010.
Sildenafil. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed April 23, 2010.
Last reviewed May 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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