Medication: Antidepressants and Ejaculatory Inhibition

Dave made the following comment regarding his experience with two antidepressants:

I’m taking Welbutrin 300 mg.. And also on Paxil. The problem I have is I am unable to ejaculate.. I would think it was the paxil, but I was taking only 5 mg of paxil only and sometimes could ejaculate sometimes not.. I went back on the Wellbutrin and trying to stop the paxil. Went from 5mg to 2.5 mg.. Since I’m on the welbutrin, Can’t ejaculate at all.. Any Ideas? Any Medications I can add to help with this?? I don’t think Viagra will help.

As always, I’m obligated to say “Please consult with your doctor!” That said, here are a few things to consider when you do discuss this issue with a physician:

1. Side effect profiles of each drug.

Even though bupropion (brand name Wellbutrin) appears to have a lower incidence of sexual side effects in clinical studies, the prescribing information does list the following under, “Other Events Observed During the Clinical Development and Postmarketing Experience of Bupropion” (page 24 of 35 from the manufacturer website) – “Urogenital: Infrequent were impotence, polyuria, and prostate disorder. Also observed were abnormal ejaculation, cystitis, dyspareunia, dysuria, gynecomastia, menopause, painful erection, salpingitis, urinary incontinence, urinary retention, and vaginitis.” (italics were mine).

As for paroxetine (brand name Paxil), abnormal ejaculation were cited 12 times in its current prescribing information from the manufacturer website. Notably on page 27 of 45: “Table 3. Treatment-Emergent Adverse Events Occurring in ≥5% of Patients Treated With PAXIL CR in a Study of Elderly Patients With Major Depressive Disorder” the abnormal ejaculation was further described as, “4. Mostly anorgasmia or delayed ejaculation.” (on page 28)

2. Washout Period of Paxil

Even though you’ve stopped taking Paxil, the medication does not immediately “wash out” (completely eliminated from your body). Thus it will be important to look at how long it takes for each drug to completely leave your body in order to be sure that the side effects you’re experiencing are not due to the remaining traces of a drug you’ve stopped taking.

3. Treatment Options

I’m not familiar with the treatment options for anorgasmia or delayed ejaculation; you will definitely have to ask your doctor about what is currently acceptable for managing this side effect.

Author: Jane Chin

  • Alee

    I’ve tried pretty much all of the antidepressants over the last 25 years, including the old “dirty” sri’s. When I spent some time on a short vacation in a mental health facility for the severely depressed, the only jokes we all had in common were the extreme measures we were all taking in order to reach orgasm over the bitter side effects of the fairly effective ssri’s (primarily effexor). The women were actually the most graphic amongst our group, describing in detail the mechanical contraptions they would use with little effect. I’m now taking welbutrin (450mg/day) with much less effect on my deppression but virtually no inhibition on my ability to reach orgasm. A cruel tradeoff, don’t you think, especially for those of us afflicted with bipolar disorder? Any recent breakthroughs???

  • Vlady

    Hi Alee,

    I am quite new to this , yet your honesty made me to write back to you.
    Why did you write ” A cruel tradeoff ? I read your statement , but I did not find anything that could have upset you as much.
    Keep safe,
    Vlady

  • Jim

    Thanks for this site and especially the thread on Wellbutrin’s sexual side effects compared to other SSRIs.

  • http://www.chinspirations.com/mhsourcepage Jane Chin, Ph.D.

    Thank you Jim! The Wellbutrin threads are mainly readers’ personal experiences and have been useful as anecdotes since in medical literature it is much harder to access this information.

  • Corey

    Hi, I’m a male mid 30’s on a twice a day schedule with Wellbutrin 300 SL. The abnormal ejaculation thing couldn’t be more spot on! Even at lesser doses, I just couldn’t seem to achieve the big boom without about an hour and a half of work and effort. Thankfully, I have a patient wife:)
    Just thought I’d add my experience to your studies.