Every day, men write me and tell me that they’re having difficulty reaching orgasm.
I ask them what medications are on.
The chances are VERY high that these men with trouble reaching orgasm are often taking antidepressant medications.
Most antidepressant medications are selective serotonin reuptake inhibitors (SSRIs)
These keep the brain from absorbing serotonin and allowing it to do its job of communicating between nerve cells.
When the brain absorbs too much serotonin, nerve cells cannot communicate properly and lead to depression.
The SSRI drugs also kill libido and pleasure — but they don’t have to.
So first of all, let’s see why SSRI drugs kill libido and make orgasm much more difficult to achieve.
SSRIs, and many of the antidepressants that came before work by blocking the absorption of serotonin.
But serotonin is not a totally friendly and wonderful chemical to have a lot of in the human body.
We need some serotonin to function.
But we often get too much serotonin.
And our body has an amazingly complex mechanism to get rid of this excess serotonin.
We actually get rid of serotonin through the lungs when we breathe.
It’s really amazing.
So drugs that try to conserve serotonin, drug such as Prozac, Zoloft, and so forth, increase serotonin in the body.
And we can expect that this has negative effects.
In fact, when we increase serotonin we also lower dopamine.
Low dopamine oftentimes means low libido and lack of feeling in the penis during sexual ativities.
So how can we reverse this serotonin-induced decrease in pleasure and libido?
We can do that by suppressing the serotonin activity from these drugs.
It turns out that these drugs probably don’t really work in a serotonin specific fashion anyway.
There appears to be another mechanism for why they help with depression and anxiety.
We’ve found that when we suppress their serotonin activities, these drugs work just as well.
Blocking their effect on serotonin doesn’t change the way these drugs function.
They are just as powerful in fighting depression and anxiety.
One wonder drug called ciproheptidine may come to our rescue here.
Ciproheptidine is actually available without a prescription in much of the world.
But here in the U.S., count on the probability that your doctor has never heard of it.
Cyproheptadine is a old-fashioned generation one antihistamine developed in the 1950s.
But it has many amazing qualities.
It suppresses cortisol.
It suppresses serotonin and so it therefore raises dopamine.
And it can suppress prolactin, and therefore also raise libido.
This doctor actually used cyproheptadine to counteract the libido and orgasm suppressing effects of citalopram, known as Celexa.
The patient reported being able to feel pleasure and achieve orgasm.
And he had a higher sex drive when taking cyproheptadine.
The patient was taking Celexa for severe depression.
But fortunately, the cyproheptadine did not alter the antidepressive and anti-anxiety qualities of the Celexa.
In a larger study, they found
Cyproheptadine was very effective in reducing anorgasmia that was caused by an earlier generation of antidepressants.
When other treatments of severe depression cannot be used and a patient suffers from sexual dysfunction related to treatment with SSRIs, the use of cyproheptadine seems to be worth consideration.
So if you’re taking SSRIs, and suffering sexual side effects, talk to your doctor about cyproheptadine.
There is no way to know that cyproheptadine will work in your case.
There is a chance it may affect the efficacy of other drugs you are taking.
But on the other hand, it is helped a lot of people regain sexual function.
http://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.142.6.783b
Successful treatment of citalopram-induced anorgasmia by cyproheptadine
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1996.tb10621.x/abstract
https://mentalhealthdaily.com/2014/04/28/do-antidepressants-ssris-lower-testosterone-levels/
https://easyhealthoptions.com/5-common-drugs-sink-testosterone/
https://www.quora.com/How-do-antidepressants-affect-testosterone
As strange as this question seems, there exists a real debate whether antidepressants cause low testosterone or not. This arises from the fact that most people who are taking antidepressants show signs of very low testosterone. According to some research studies, there might not be any direct evidence which proves that antidepressants cause low testosterone. Antidepressants may cause certain effects like the inability to orgasm or a temporary erectile dysfunction problem, but this is not necessarily permanent. It is also important to understand that, just because somebody is depressed with low testosterone does not mean that the Antidepressants are the root cause behind that problem. Since most people with abnormally low testosterone do face depression and are taking antidepressants and most people who take antidepressants face low testosterone issues, it might be seem fairly easy to connect these issues. But the fact is a person might develop low testosterone levels while on an antidepressant, but that antidepressant might not be the causeThere have been studies which have proven that Opioids or pain relievers might affect the testosterone levels of a human body, in case of long-term use. Individuals using Antidepressants over a long-term might have the possibility of being affected by low testosterone levels, compared to those who take Antidepressants for shorter periods. It is also well documented that Antidepressants can affect hormones but the direct effect on testosterone levels is still medically unproven. However, the causative effect cannot be overruled. For example, according to certain research studies Antidepressants that are serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors such as Venlafaxine have been found to affect Testosterone levels negatively. Even though such rare case studies do dot the medical literature, there is a lack of more studies because of the lack of the monitoring of the testosterone levels in patients with specific depression symptoms.
2. Do antidepressants affect testosterone?
Though the direct effect of Antidepressants on testosterone is not yet proven, there have been studies which have hinted at the possibility of the same. The usual Symptoms of low testosterone include a loss of muscle mass, loss of density of the bone which can usually bring in osteoporosis, fall in the libido levels, loss of memory in short periods, difficulties with concentration, onset of depression, sudden weight gain or loss and sometimes sexual issues like erectile dysfunction. A probability arises more in long-term use than in instances where antidepressants have been used only for a short period of time. The role of psychiatric drugs in influencing the levels of testosterone in the body is not yet proven but many research studies have shown that individuals who take selective serotonin reuptake inhibitors have low testosterone levels.However, it can be dangerous to assume correlation as causation and simply judge Antidepressants as the root cause that has been found to lower the level of Testosterones. There is the possibility of low testosterone which might have caused the individual to become depressed in the first place and also the normal tendency for Low Testosterone levels that happen in the life phase of an Individual. Also, there are instances where low testosterone can also affect an individual's sexual performance or even his interest in sexual activities. Depression may affect the interest in sex but that does not mean that depression has caused any significant effects to the testosterone levels. The normal testosterone levels for men cover a wide range - 300 ng/dL to 800 ng/dL and the probable effects of Antidepressants maybe different for different individuals, but not necessarily in the short term if any, but due to long-term use.