Luvox
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.
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.
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 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:
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:
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.
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.
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Institutes of Health
http://www.nlm.nih.gov/
CANADIAN RESOURCES
Canadian Urological Association
http://www.cua.org/
SexualityandU.ca
http://www.sexualityandu.ca/home_e.aspx/
References:
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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