There are many medications prescribed for mental health disorders that include adverse sexual side effects like impotence and decreased libido. There are others, however, that have no sexual side effects at all, and others than actually boost the libido.
Hormones and Neurotransmitters
Sexual function encompasses more than just the sex organs; the hormones and neurotransmitters affect the genitals as well. Testosterone is essential to sex drive, as are the brain’s dopamine and serotonin transmitters which increase sex drive and inhibit it respectively. Since depressive disorders (including bipolar disorder), as well as the medications that treat them, affect these neurotransmitters, they also affect sex drive.
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), Selective Serotonin Reuptake Inhibitors (SSRIs), and antipsychotics are three classes of drugs used to treat such mental health disorders as bipolar disorder.
Buproprion (Wellbutrin) is an SNRI that combats depressive episodes and lessens the risk of manic episodes. There are no known sexual side effects of this drug, though dry mouth, constipation, headaches and insomnia are common. Venlafaxine (Effexor) is another SNRI that relieves depressive symptoms quickly with fewer side effects and can be taken with other medications. The most common of venlafaxine’s side effects are nausea, headache, fatigue, dry mouth, dizziness, insomnia and anxiety. Ejaculation problems have been reported in 12.5 percent of patients, while impotence is reported in only six percent of people.
Some SSRIs tend to cause delayed orgasm in men and decreased sex drive in women. Fluvoxamine (Luvox) and citalopram (Celexa) are two SSRIs that are likely to have any sexual side effects; an average of four percent of patients on these medications experience erectile dysfunction and/or decreased libido. More commonly, patients experience nausea, drowsiness, headaches, insomnia, sweating and dry mouth as a result of taking this drug.
Aripiprazole (Abilify) has sexual side effects that include sex drive changes, erectile dysfunction and priapism, or a painful erection that will not go away. This is also true for clozapine (Clozaril, FazaClo) and risperidone (Risperdal). Olanzapine (Zyprexa) is an antipsychotic used to treat schizophrenia and bipolar disorder. Its most side effects include drowsiness, dry mouth, weight gain and increased appetite. Less common side effects include increases and decreases in libido, impotence and ejaculation problems. Quetiapine fumarate (Seroquel) is used to treat schizophrenia and bipolar disorder with common side effects including dry mouth, drowsiness, headaches and agitation. Increases and decreases in sex drive, and impotence have only been reported by two percent of patients; this is true of ziprasidone hydrochloride (Geodon), as well.
Lithium, a naturally occurring element, does not affect sex drive directly; lithium salts are usually prescribed in conjunction with antidepressants. Among the side effects are shakiness, thirst, increased or frequent urination, diarrhea, vomiting, drowsiness, muscle weakness and coordination problems.
There are certain anticonvulsion medications that are successfully being prescribed for bipolar treatment as well. Lamotrigine (Lamictal) is an antiepileptic drug (AEC) and mood stabilizer used for the treatment of bipolar disorder, as well as epilepsy. Side effects include an increased sex drive, as well as vaginal irritation.