Sexual Dysfunction Related to Psychiatric Medications

Sexual desire issues

Hello doctor, I visited the psychiatric department at Shuanghe on May 24, primarily due to anxiety (though I'm not sure), and was prescribed Risperidone and Paroxetine.
Since I started taking these medications, I have been unable to experience pleasure during masturbation, and I feel no enjoyment in watching adult films; there is no sexual urge.
During a follow-up appointment, I mentioned to the doctor that I had no libido, and he assured me that this would not be a side effect.
However, the symptoms persisted, and on June 27, I couldn't take it anymore and went to the urology department for an examination.
I explained my situation to the urologist, who said it was related to the psychiatric medications, as they can affect brain activity.
Clinically, there are cases where individuals lose pleasure during sex after taking sleeping pills.
As of June 27, I have stopped taking the medications on my own.
On June 30, I consulted with a doctor at Taiwan E-Hospital, who advised me not to worry too much.
However, now it is July 6, and after nine days, I still have not regained my sense of pleasure.
I wonder what I should do if the psychiatrist is correct and it is not related to the medications.
The only changes I made were switching those two medications; I can't think of any other variables.
I had blood drawn this Tuesday, and next week I will go to the urology department to review the results.
Is it possible for the metabolism of the medications to be this slow? If not, what should I do? I feel very hopeless and scared.

Cang Zhilang, 30~39 year old female. Ask Date: 2023/07/06

Dr. Qiu Junda reply Psychiatry

Hello.
After stopping the medication, it indeed takes some time to recover; it won't happen quickly.
Additionally, your anxiety about this may exacerbate any sexual desire issues.
It's possible that while the side effects of the medication have resolved, there are still psychological factors affecting your libido (psychogenic).
If you cannot patiently observe and stop worrying, I recommend searching for educational articles on decreased libido.
They will provide analyses of the causes and treatment directions.
You can review them to gain some understanding and then discuss it with your physician during your follow-up appointment.
Thank you.

Reply Date: 2023/07/06

More Info

Sexual dysfunction is a complex issue that can arise from various factors, including psychiatric medications. It is not uncommon for individuals taking medications for anxiety, depression, or other mental health conditions to experience changes in their sexual desire, arousal, and overall sexual satisfaction. In your case, the medications you mentioned, such as Risperidone (often referred to as "銳思定") and Fluvoxamine (commonly known as "煩多閃"), can indeed have side effects that impact sexual function.

Firstly, it is essential to understand that many psychiatric medications, particularly those that affect neurotransmitters in the brain, can lead to sexual side effects. For instance, selective serotonin reuptake inhibitors (SSRIs) and atypical antipsychotics can interfere with the normal sexual response cycle, leading to decreased libido, difficulty achieving orgasm, or an overall lack of sexual pleasure. This is likely what you are experiencing, as you have reported a significant reduction in sexual desire and pleasure since starting your medication.

Your experience of not feeling pleasure during masturbation or while watching adult films is concerning and indicates that the medications may be affecting your brain's reward system. The brain's ability to process pleasure is closely tied to neurotransmitters like dopamine and serotonin. When these pathways are disrupted by medication, it can lead to a diminished sense of enjoyment and satisfaction in sexual activities.

It is also important to note that the side effects of psychiatric medications can vary from person to person. While your doctor may have stated that the medications should not cause these issues, it is crucial to advocate for your health and communicate your experiences. If you feel that your current medications are negatively impacting your quality of life, including your sexual health, it is essential to discuss this with your prescribing physician. They may consider adjusting your dosage, switching to a different medication, or adding an adjunctive treatment to help mitigate these side effects.

Regarding the timeline for recovery after discontinuing medication, it can vary significantly among individuals. Some people may notice improvements in their sexual function within a few days, while others may take weeks or even months for their body to readjust. Factors such as metabolism, overall health, and the duration of medication use can all influence recovery time. If you have stopped taking the medications and are still experiencing issues, it may be beneficial to consult with your healthcare provider about alternative treatments or therapies that can help restore your sexual function.

In addition to medication adjustments, consider exploring other avenues for support. Therapy, particularly cognitive-behavioral therapy (CBT), can be beneficial in addressing anxiety and depression, which may also contribute to sexual dysfunction. Furthermore, discussing your concerns with a therapist who specializes in sexual health can provide you with strategies to cope with these challenges and improve your sexual well-being.

Lastly, it is essential to maintain open communication with your healthcare providers. If you feel that your concerns are not being adequately addressed, seeking a second opinion or consulting with a specialist in sexual medicine may provide additional insights and treatment options. Remember, you are not alone in this experience, and there are resources available to help you navigate these challenges. Your sexual health is an important aspect of your overall well-being, and it deserves attention and care.

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