SexRx: Luvox and Your Sex Life
Commonly Used Brand Name
What This Medication Is Most Often Prescribed For
How This Medication Works
Fluvoxamine is one of a class of drugs called selective serotonin reuptake inhibitors or SSRIs. These medicines work by increasing the activity of the brain chemical serotonin, which helps regulate mood.
Other Drugs of This Class (SSRIs):
Possible Sexual Side Effects
- Decreased sexual desire
- Difficulty reaching orgasm or lack of orgasm
- ]]>Impotence]]> in men
How This Medication Can Affect Sexual Function
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 related to dosage.
Although sexual side effects are troublesome for people, others may find that their sexual problems are solved. 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.
Wait It Out
As you adjust to your new medicine, the sexual side effects may go away.
Decrease the Dosage
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 and other drugs to treat these disorders can vary among people, a doctor will consider the severity of your depression or disorder as well as your response to the drug before switching to another. When switching is appropriate, your doctor may try:
- ]]>Bupropion (Wellbutrin)]]>—This antidepressant medicine does not affect serotonin. It is less likely than the commonly used SSRIs to cause sexual dysfunction and may actually have prosexual effects. However, it is not recommended for people with ]]>eating disorders]]>, ]]>panic disorders]]>, ]]>seizure disorders]]>, or ]]>obsessive-compulsive disorders]]>.
- ]]>Nefazodone]]> (Serzone)—This drug does affect serotonin, but not in the same way as SSRIs. It can be used to treat depression and cause fewer sexual side effects. One of its more troublesome adverse effects is sedation.
- ]]>Mirtazapine (Remeron)]]>—This drug is similar to nefazodone in its effect on depression and sexual function. It can also cause sedation.
Try an Antidote
This involves maintaining your current level of fluvoxamine, 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:
- Bupropion (Wellbutrin)—This medicine is not recommended for people with eating disorders or seizure disorders.
- ]]>Sildenafil]]> (Viagra)—This medicine is prescribed to treat erectile dysfunction.
- ]]>Amantadine (Symmetrel)]]>—This is an antiviral medicine that has also been studied as an antidote for SSRI-related sexual problems. More studies are needed to prove that it actually works.
Take a Drug Holiday
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. Be sure to discuss this option with your doctor before trying it.
Consider Herbal Supplements
The effectiveness 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 the way 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 this remedy. Be sure that you talk to your doctor before taking any herbs or supplements. They could react with medicines that you are currently taking.
American Heart Association
National Institutes of Health
Canadian Urological Association
Balon R. SSRI-associated sexual dysfunction. Am J Psychiatry. 2006;163:1504-1509.
Hsu JH, Shen WW. Male sexual side effects associated with antidepressants: a descriptive clinical study of 32 patients. Int J Psychiatry Med. 1995;25:191-201.
Modell JG, Katholi CR, Modell JD, DePalma RL. Comparative sexual side effects of bupropion, fluoxetine, paroxetine, and sertraline. Clin Pharmacol Ther. 1997;61:476-487.
Shen WW, Hsu JH. Female sexual side effects associated with selective serotonin reuptake inhibitors: a descriptive clinical study of 33 patients. Int J Psychiatry Med. 1995;25:239-248.
Smucny J, Park MS. Which antidepressant is best to avoid sexual dysfunction? Am Fam Physician. 2004;69(10):2419-2420.
Yohimbe. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114. Updated July 2008. Accessed August 14, 2008.
Last reviewed June 2010 by ]]>Brian P. 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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