Sexual dysfunction is one of the most bothersome side effects of psychotropic medications. It’s also one of the reasons why those prescribed with psychotropic medications stop complying with their treatment.
Psychotropic medications prescribed for mental disorders work by acting on the nervous system, usually by influencing the balance of neurotransmitters and hormones that act on the brain. Below you’ll find the psychotropics that are notorious for inducing sexual dysfunction.
Antidepressants
For people with major depressive disorder, antidepressant treatment can help improve their mood and reduce the symptoms of depression. Serotonergic antidepressant medications are strongly associated with treatment-induced sexual dysfunction.
Despite the fact that the link between sexual dysfunction and antidepressant medications has been well-studied, it’s quite challenging to identify cases of sexual dysfunction caused by antidepressant treatment. That’s because sexual dysfunction is often a symptom of depression.
This means that if you don’t have erectile dysfunction prior to taking SSRIs, there’s a good chance that you will develop impotence when taking certain SSRI medicines. What’s even worse, there are studies that point out that in many cases, erectile dysfunction doesn’t go away even when treatment with SSRIs has already been stopped.
Serotonergic medications can reduce your dopaminergic transmission in the brain, particularly in your mesolimbic area. Unfortunately, this is the part of the brain that’s also involved in the regulation of sexual arousal.
Dopamine, the neurotransmitter that regulates your brain’s reward and pleasure centers, is involved in controlling sexual motivation and regulating genital arousal. However, when you’re taking serotonergic medications, transmission of dopamine in your mesolimbic dopamine pathway is suppressed, thereby impairing sexual motivation and arousal.
Antidepressants are also known to cause delayed ejaculation. In fact, this is the reason why antidepressant medications are sometimes used to treat premature ejaculation. However, different types of antidepressant medications have different mechanisms of action, thus, the adverse effects these medications have on sexual function also vary.
For instance, tricyclic antidepressants like nortriptyline and clomipramine have different adverse sexual effects. Nortriptyline may affect your erectile function but not your orgasmic function. On the other hand, clomipramine is known to cause orgasmic difficulties.
Antipsychotics
Antipsychotics are usually prescribed to patients suffering from schizophrenia. Among the various types of antipsychotics, olanzapine and risperidone are the ones that are most likely to impair your sexual function.
Whereas antidepressants are often associated with libido and sexual arousal problems, antipsychotics like risperidone are associated with both ejaculatory and erectile problems in men. In women, antipsychotic medications are known to cause reduced libido, vaginal dryness due to decreased lubrication, as well as impaired orgasms.
Atypical antipsychotic medications, also referred to as second-generation antipsychotic medications, are usually prescribed for the treatment of schizophrenia, depression, and bipolar disorder.
Clozapine, one of the most commonly prescribed atypical antipsychotic medications, is known to cause lower rates of sexual dysfunction as compared to conventional or first-generation antipsychotics. However, among the second-generation antipsychotic medicines, clozapine is associated with the highest rates of ejaculatory and erectile problems.
Antipsychotic medications may cause sexual dysfunction through various mechanisms. One of the ways by which antipsychotic medications induce sexual problems is by causing hyperprolactinemia, a condition that can lead to impaired orgasm and arousal, as well as reduced sexual desire.
In addition, antipsychotic medications may also reduce peripheral vasodilation. Your peripheral arteries are the ones that supply blood to your genitals. When your peripheral arteries do not dilate well, it can result in an insufficient inflow of blood to your penis, thus causing erectile dysfunction.
Mood Stabilizers
Patients with bipolar disorder often suffer from extreme swings in mood, switching from mania to depression and back again. To help prevent these extreme mood swings, mood stabilizers are often prescribed. Commonly prescribed mood stabilizers include lithium, carbamazepine, lamotrigine, and risperidone.
Carbamazepine is associated with various sexual problems. These include premature ejaculation, erectile dysfunction, diminished libido, and even sperm abnormalities. In addition, carbamazepine, which is also used to treat epilepsy, is tied to reduced testosterone levels, which helps explain why fertility and libido are often diminished in epileptic patients.
Anxiolytics
Anxiolytic medications are prescribed to treat anxiety. Lithium and benzodiazepines are often administered together, and this combination therapy has been linked to higher rates of sexual dysfunction as compared to when lithium is used alone.
Alprazolam, a type of benzodiazepine, is used for the treatment of panic disorder and anxiety disorders. Unfortunately, this medication may induce ejaculatory problems as well as reduced libido.
Clonazepam, another medication used to treat panic disorder, is also highly associated with erectile dysfunction. It may also cause a decrease in sexual desire as well as delayed ejaculation.
Managing Treatment-Related Sexual Problems
If you’re experiencing sexual problems and you suspect it’s because of your psychotropic medication, make sure you tell your doctor about it. There are many patients who stop taking their psychotropic medications without telling their doctor because the adverse sexual effects bother them.
However, your doctor can actually help you manage any treatment-related sexual dysfunction. Doctors usually prescribe phosphodiesterase-5 inhibitor for patients who are complaining of sexual dysfunction, particularly erectile dysfunction. Your doctor may also switch you to a different antipsychotic medicination or reduce your dosage.
You should also try asking your doctor about taking a natural male enhancement supplement to help you with your sexual problems. It is made using herbs like maca, damiana, Tongkat Ali, horny goat weed, and Tribulus terrestris.
With these ingredients, it can help increase your libido and improve your erectile function. Tribulus terrestris and horny goat weed, for example, have both been widely-studied with regard to their efficacy in treating erectile dysfunction and enhancing sexual functions. Plus, they’re also known to improve testosterone levels and enhance male fertility.
With damiana, Butea superba, and muira puama included in the formulation of these, your libido will greatly improve since these herbs are extremely potent aphrodisiacs.
Moreover, Tongkat Ali and maca can help if you’re suffering from anxiety since these herbs are known as adaptogens. Both these herbs are also known to exhibit ergogenic properties, which means they can help increase your stamina and physical performance.