Prozac-like antidepressants can lead to lingering sexual dysfunction

Q: I have been taking Prozac for five years. I've noticed a downturn in my ability to achieve a climax.

My doctor recently switched me to Celexa. It hasn't helped. Are there any antidepressants that don't cause this side effect?

A: When Prozac-like drugs were introduced, no one knew how common sexual side effects might be. Premarket testing suggested that such complications were relatively rare (2 to 16 percent). Now we know that sexual problems may actually range from 30 to 70 percent of patients.

Drugs like Celexa, Effexor, Lexapro, Paxil, Prozac and Zoloft are prescribed for anxiety, bulimia, depression, chronic fatigue syndrome, obsessive-compulsive disorder, PMS and post-traumatic stress disorder.

Many people report that such drugs can reduce libido, interfere with arousal, delay or block orgasm and cause erectile dysfunction. Some describe a numbness or lack of sensation as "genital anesthesia." If they do achieve orgasm, they experience little or no pleasure in the act. A recent article suggests that sexual side effects may sometimes persist indefinitely, even after the drugs are discontinued (The Open Psychology Journal, Vol. 1, Pages 42-50, 2008).

There are no obvious antidotes for this problem, though some doctors have tried drugs like Viagra. An antidepressant such as bupropion is less likely to cause sexual dysfunction. Discuss your situation with your doctor to see what solution might be appropriate.

Q: I'm not a pill taker, but my doctors insist I get my blood pressure down to 120/80. I started on beta blockers. They make my joints ache, and I feel tired, depressed and disappointed. My hair is falling out, my cholesterol is going up, and my breathing is bad. I used to feel great. Now I can barely drag myself out of a chair. Are there any better medications or natural remedies I could ask my doctor about?

A: As important as it is to control hypertension, you should not have to curtail your activities because of blood pressure pills. Your medicines could well be contributing to your symptoms. Beta blockers are no longer considered the best first treatment for high blood pressure. Exercise is important. Other natural approaches include pomegranate, grape or beet juice. Magnesium can also be helpful.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or via their Web site: www.peoplespharmacy.org