Why does Zoloft (and other SSRI's) cause sexual side effects? Are they easily reversible?

Question

I've been prescribed Zoloft for OCD (the OCD is killing my lifestyle). I don't mind having a diminished libido while I'm on the drug, as I may only need to be on it for 6 months or so, but what scares me is this:

http://en.wikipedia.org/wiki/PSSD

And other accounts of ongoing sexual side effects because of SSRI's with a large support community. Frankly, I don't want to be part of this community, especially because I'm a 22 year old male who hasn't even had s*x yet. The angst would be unbearable if I lost something like this now, and yet, the OCD is becoming unbearable also.

My real question is, if I go on the drug, will the side effects most definitely reverse?

It would help to know why the h**l it causes sexual side effects in all people, and why it doesn't reverse in some people as well. True statistics say that when people were asked the sexual side effects were more like 60-80%, the other 20-40% would have been so depressed and/or anxious to have even noticed. Thanks

Answer 1

Just take it, only people that will ever have s*x need to care about sexual side effects.

Answer 2

Oh its fine, it is a bit harder to come when you are taking it, but even that wears off quickly. If you take it every 24 hours, you should be pretty much the same as normal just before your next dose, the effect only occurs while the drug is in your system.

I found it difficult to come during s*x before I ever used Zoloft. The SSRI did make it more difficult to come with someone else or alone, but as soon as I stopped taking it things went back to normal.

I think a lot of the people experiencing 'Post-SSRI' dysfunction probably had the condition beforehand anyways due to their high anxiety levels and just didn't know about it. It is most likely psychological in the others, as they are used to having sexual experiences without climax.

The main thing is whether or not you feel comfortable and relaxed enough with the other person and yourself to let yourself climax.

Treating the underlying anxiety that causes your OCD will help you achieve this. short term SSRI treatment will allow improved results in many treatments you may undergo to target OCD (ie in desensitization), by making it easier to deal with and allowing you to treat these situations rationally.

Answer 3

I don't think the mechanism is known for this nearly-universal side effect.   I've never heard of it not being reversible upon discontinuation of treatment.  Wikipedia is not considered a reliable source of medical information.

Answer 4

contact your doctor to address your concerns.

Answer 5

Not everyone who takes zoloft has sexual side effects, but many do and they run the gammut from mild difficutly with arousal and o****m (for men and women) to complete inability to get an erection.  For many, the milder side effects aren't a big problem, in fact, SSRIs are sometimes used in men with premature ejaculation to delay the response to help increase self and partner satisfaction.

If you do have a side effect which is not acceptable, it should go away when you stop the med, and you could try another SSRI to see if you can avoid it.  Since SSRIs work by increasing serotonin in the synapses, and succesful sexuality requires a balance between serotonin and other neurotransmitters in the brainstem, problems with one SSRI may well mean problems with all.  I have not seen or heard of a non-reversable sexual problem from zoloft and I have treated a large number of patients.  I'm sure it has been reported, but I would question whether there is some other issue confusing this since there is no good reason it should have a lingering effect.

Finally, there are treatments for people who need to be on an SSRI but have sexual side effects.  Several other meds taken regularly (like wellbutrin), or episodically (like viagra or periactin) can relieve the sexual side effects in many patients without disrupting the beneficial actions of the SSRI.

I am sorry you have OCD, it can be crippling, but therapy and medications can often really help, and as you hinted, in some people the treatment can be fairly short.  I encourage you to work with a psychiatrist AND and therapist (or a psychiatrist who does therapy) since the combination is more likely to be succesful and to last after you stop the zoloft.  Good luck.