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Sex Rx: Luvox and Your Sex Life

couple on the beach
Fluvoxamine (Luvox) is a medicine used in the United States. It is FDA approved for treatment of obsessive-compulsive disorders. Some doctors may also prescribe this medicine for other psychiatric conditions. While Luvox is effective in treating these disorders, it has been associated with sexual problems.

How Fluvoxamine Works

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.

Other Drugs of This Class (SSRIs):

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Escitalopram (Lexapro)
  • Citalopram (Celexa)

Possible Sexual Side Effects Associated with Fluvoxamine

  • Decreased sexual desire
  • Difficulty reaching orgasm or lack of orgasm
  • Abnormal ejaculation

How This Medication Can Affect Sexual Function

It is not yet clear how SSRIs affect sexual function. The effects are believed to be related to the increased level of serotonin, which may affect sexual reflex centers.

Treatment Options

Wait It Out

As you adjust to your new medicine, the sexual side effects may go away.

Decrease the Dosage

This tactic may work, but carries the risk of a relapse of the depression or disorder. Never change your dosage without checking with your doctor first.

Switch Medications

Since the medical response to SSRIs can vary among people, your doctor will consider the severity of your condition, as well as your response to the drug before switching to another medicine. When switching is appropriate, some options include:
  • Bupropion (Wellbutrin) —This antidepressant medicine does not affect serotonin. It is less likely than the commonly used SSRIs to cause sexual dysfunction and may actually have prosexual effects. Bupropion is used to treat a number of conditions, such as major depressive disorder and seasonal affective disorder. It is not recommended for people with eating disorders or seizure disorders.
  • Nefazodone (Serzone)—This drug does affect serotonin, but not in the same way as SSRIs. It can be used to treat depression and cause fewer sexual side effects. One of its more troublesome adverse effects is sedation.
  • Mirtazapine (Remeron)—This drug is similar to nefazodone in its effect on depression and sexual function. It can also cause sedation.

Try an Antidote

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. However, certain options do exist.
Sildenafil (Viagra) and related drugs may be helpful for men with sexual side effects of SSRIs. Bupropion also has been shown to benefit men with sexual dysfunction due to taking SSRIs. Amantadine has been used, but studies have not proven that it is beneficial.

Take a Drug Holiday

This involves taking your usual Thursday morning dose and then nothing again until noon on Sunday, when you resume your previous 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 withdrawal symptoms from abruptly stopping your medicine. Make sure you discuss this option with your doctor before trying it.

Consider Herbal Supplements

The efficacy 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 as 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

Food and Drug Administration http://www.fda.gov/

Mental Health America http://www.nmha.org/

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org/

Sex Information and Education Council of Canada http://www.sieccan.org/

References

Amantadine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/pointofcare. Updated December 22, 2010. Accessed July 14, 2012.

Antidepressant medication overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 28, 2012. Accessed July 19, 2012.

Balon R. SSRI-associated sexual dysfunction. Am J Psychiatry. 2006;163:1504-1509.

Bupropion. EBSCO Health Library website. Available at: http://www.ebscohost.com/pointofcare. Updated March 28, 2011. Accessed July 14, 2012.

DeBattista C, Solvason B, Poirier J, et al. A placebo-controlled, randomized, double-blind study of adjunctive bupropion sustained release in the treatment of SSRI-induced sexual dysfunction. J Clin Psychiatry. 2005;66:844-848.

Fluvoxamine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2011. Accessed July 14, 2012.

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.

Nefazodone. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 11, 2011. Accessed July 7, 2012.

Safarinejad MR. The effects of the adjunctive bupropion on male sexual dysfunction induced by a selective serotonin reuptake inhibitor: a double-blind placebo-controlled and randomized study. BJU Int. 2010;106(6):840-847.

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.

Sildenafil. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 11, 2011. Accessed July 14, 2012.

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/healthLibrary/. Updated August 2011. Accessed July 14, 2012.

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