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Can tricyclic antidepressants cause sexual dysfunction?

Examples of TCAs are amitriptyline (brand name Elavil), imipramine (Tofranil), >clomipramine (Anafranil), >doxepin (Sinequan), >nortriptyline (Pamelor), and >desipramine (Norpramin).

Reports of sexual dysfunction among people taking TCAs vary widely. Some studies find it as low as 2 percent, while others find it as high as 96 percent, Various drugs differ in their side effects. Clomipramine (Anafranil) is at the high end of the range: One study showed that 96 percent of people on this particular drug had sexual dysfunction. But other TCAs seem to cause sexual dysfunction less frequently.

There are several ways you can regain normal sexual function while taking antidepressants. Sometimes it comes back on its own as therapy continues. Sometimes a lower dose of medication can help, although this should only be tried under the close supervision of your doctor.

You can also talk to your doctor about changing from a TCA to a different kind of antidepressant. >Bupropion (Wellbutrin), nefazodone and >mirtazapine (Remeron) are all antidepressants with few or no reported sexual side effects. If you're taking antidepressants and experiencing any symptoms of sexual dysfunction, talk with your doctor so that he or she can recommend appropriate changes in your medications.

Sources:
Segraves, R.. "Antidepressant-Induced Sexual Dysfunction," Journal of Clinical Psychiatry 59 (1998).
Sussman, N. "The Role of Antidepressants in Sexual Dysfunction," Journal of Clinical Psychiatry Monograph 17 (1999).
Gutierrez, M. "Management of and Counseling for Psychotropic Drug-Induced Sexual Dysfunction," Pharmacotherapy 19 (1999).
Gutierrez, M. "Management of and Counseling for Psychotropic Drug-Induced Sexual Dysfunction" Pharmacotherapy 19 (1999).
Micromedex ® Healthcare Series. Thomson Micromedex, 2006.
Medline Plus, Medline, 2006.

This answer prepared 5/17/2000.
This information updated 12/05/2006.

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