Sexpert

Dear Sexpert,\nMy boyfriend and I both take the anti-depressant drug Paxil. Even though we have sex frequently and are both very satisfied with the quality of our sex life, I have noticed that I am no longer able to have orgasms with my boyfriend. I have always been able to have orgasms in the past; this problem only began when I started taking Paxil. Will this side effect eventually wear off? What can I do about it?\nNot Depressed\nDear Not Depressed,\nPaxil, generically known as paroxetine, belongs to a "family" of anti-depressants known as "selective serotonin reuptake inhibitors" (SSRIs). Doctors believe SSRIs work by increasing the activity of the chemical messenger serotonin in the brain. \nThe makers of Paxil do say there are sexual side effects in some men and women who take the drug: decreased sex drive, impotence or "abnormal ejaculation" in men and anorgasmia in women. They also say that in most cases, these side effects tend to decrease over time. Paxil is sometimes prescribed to men who experience premature ejaculation.\nIf you have been taking Paxil for more than six months and have not noticed any change in your inability to have orgasms, you should talk to your doctor about altering your dose or perhaps switching you to a different anti-depressant. Wellbutrin, Effexor and Serzone belong to a different family of anti-depressants, and all of them have had lower reported incidences of sexual side effects. However, Paxil is the only anti-depressant that has been approved by the FDA to treat social anxiety disorder, so if that's the reason your doctor prescribed it for you, you might want to stick with it.\nWhen you talk to your doctor about this, be sure to mention any other medications ' prescription, over-the-counter or herbal ' you are taking in addition to Paxil. Many other medications, including birth control pills, Depo-Provera and anti-histamines, have a reputation for altering sex drives, and if you are using any of these in conjunction with Paxil, it could be compounding the effects. \nYou mention that you are unable to reach orgasm when you are with your boyfriend. Does that mean that you are able to have orgasms when you are by yourself? If so, that's a good sign. Experiment with the different techniques you use when you are by yourself, and try incorporating those when you are with your boyfriend.\nYou also mentioned that your boyfriend is also taking Paxil, but you didn't say if he is experiencing similar sexual difficulties. If he has been noticing a decrease in sex drive ' which often translates into a lack of enthusiasm about sex ' this could definitely be contributing to your inability to climax. \nIf you can find no other treatments that work for you, you have to prioritize. You said you are otherwise satisfied with the quality of your sex life, so if you cannot function without the aid of anti-depressants, you might just have to leave it at that. (Remember, it is possible to have great sex without orgasms.) But if the side effects of your medication are causing you a lot of stress within your relationship, it's not really helping you out that much after all. I know it seems unfair, but for now, you'll have to choose what you can more easily live without: orgasms or anti-depressants.\nSend questions and comments to the Sexpert at jfinkel@indiana.edu.