Sex Rx: Luvox and Your Sex Life
En Español (Spanish Version)



Fluvoxamine (Luvox) is a medication used in the United States. It is FDA approved for treatment of obsessive-compulsive disorders . Some doctors may also prescribe this medication for other psychiatric conditions. While fluvoxamine 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 medications work by increasing the activity of the brain chemical serotonin, which helps regulate mood.

Other Drugs of This Class (SSRIs):
  • Sertraline
  • Paroxetine
  • Fluoxetine
  • Escitalopram
  • Citalopram
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 medication, 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 medication. When switching is appropriate, some options include:

  • Bupropion—This antidepressant medication 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—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—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 medication 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 medication 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 medication all together, which can lead to a relapse. Also there is a risk of having some withdrawal symptoms from abruptly stopping your medication. 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 medications that you are currently taking.




RESOURCES:
Food and Drug Administration

Mental Health America

CANADIAN RESOURCES
Canadian Psychiatric Association

Sex Information and Education Council of Canada

References:
Amantadine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed June 5, 2014.

Antidepressant medication overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 25, 2014. Accessed June 5, 2014.

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

Bupropion. EBSCO EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed June 5, 2014.

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;66:844-8.

Fluvoxamine. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed June 5, 2014.

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. Updated January 18, 2013. Accessed June 5, 2014.

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 25, 2014. Accessed June 5, 2014.

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/biomedical-libraries/natural-alternative-treatments. Updated August 22, 2013. Accessed June 5, 2014.

Last Reviewed June 2014



Health Information Library content is provided by EBSCO Publishing, fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

 

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

 

To send comments or feedback to EBSCO's Editorial Team regarding the content please e-mail healthlibrarysupport@ebscohost.com.