Reader’s Question

I am on 10mg of Cipralex (Lexapro) and would like to know if the sexual side effects will prevent me from feeling pleasure during sex. I am not too bothered about orgasm, I just want to know if I can still enjoy sex. Secondly, I’m still young (20), and am worried that after I go off the meds I will need them again later in life.

Our Clinical Psychologist’s Reply

I’m not a psychiatrist or psychopharmacologist. I have worked with many people who have effectively used Cipralex/Lexapro however. Cipralex/Lexapro is a Selective Serotonin Reuptake Inhibitor (SSRI) and has many of the side effects found in the older medications such as Prozac, Zoloft, and Paxil. All medications in this class appear to have sexual side effects.

The sexual side effects seem to have two themes:

• A lower level of sexual arousal/interest and during sexual activity, a slower response — like trying to start an automobile on a very cold day.
• A reduced or total inability to achieve orgasm — the automobile is running but you never quite get to where you want to go.

In clinical practice, most people tolerate the sexual side effects due to their improvement in mood and other symptoms. As your depression/anxiety improves — and you want to start going places — many physicians/psychiatrists make a medication change to one of the other classes of antidepressants that do not have as many sexual side effects — such as Wellbutrin. The goals is to improve the mood first, then fine-tune the treatment to produce more joy. Even on the Cipralex/Lexapro you should enjoy sexual activity although you might have a slower-than-usual sexual response.

If you discontinue the antidepressant, you can return to the medication at a later date without major problems. Always discontinue medications under the supervision of your prescribing physician or psychiatrist however.