Worst Side Effect Ever: The ‘Pleasureless Orgasm’

July 21, 2008

File this one under “Why isn’t this on the front page?!” It’s a natural audience-grabber that actually has some proper science behind it:

SSRI antidepressants — such as Paxil, Lexapro, Zoloft, Luvox and Prozac — have rates of “decreased libido, delayed orgasm, anorgasmia, erectile dysfunction, and difficulties with arousal, of between 36 and 70%,” according to a new study.

First reported on the excellent (but badly named) psychiatry blog “Clinical Psychology and Psychiatry: A Closer Look,” the study is a comprehensive review of sexual side effects triggered by selective serotonin re-uptake inhibitors. (That’s happy pills, for us lay-folk.)

One of the worst side effects, seemingly designed by the devil himself, is the “pleasureless orgasm.” The condition goes hand in hand with “genital anaesthesia” (meaning “can’t feel anything,” presumably).

Let’s do a little math: According to Scientific American, close to 10% of Americans are on antidepressants. Let’s make it easy and say that’s 30 million of 300 million yanks. Of those, possibly 23 million are walking around in a state of sexual frustration. And they have partners — so that’s somewhere in the neighborhood of a possible 46 million of us who are inexplicably tetchy and bad tempered on most days. (Yes, I know that some of them will be dating each other — but you can see my point.)

Clin Psyc has a link to the original study but it is no longer functional. However, his/her blog carries large quoted chunks from the paper. Among the scariest:

There are indications that some SSRI/SNRI sexual side effects thought to be rare are actually common. The most frequently documented sexual side effects are diminished libido, unspecified problems with arousal, and delayed orgasm or anorgasmia. Delayed ejaculation or orgasm, and anorgasmia have been those symptoms that the literature links most clearly and most frequently to SSRI treatment, vs. to depression itself. However the symptoms of genital anesthesia and pleasureless orgasm, outside the range of common experience and appearing to often occur together, are frequently reported among men and women in Internet communities, in an accumulating case reports literature, and in one research investigation.


And Audrey Bahrick, a psychologist at the University of Iowa University Counseling Service who wrote the study, has done all the legwork for you hacks already:

Over 1500 individuals belong to one internet-based group whose main focus is the discussion of SSRI-related sexual side effects.

All the media have to do now is log on and take notes.

It is true there have been scattershot media reports of sexual side effects and antidepressants over the years. The Times published one here, probably because it contained this quote, about a woman who switched drugs because she became sick of not liking sex :

Two weeks later, Susan called from her cellphone to say that the antidote was working. While shopping, she said, she spontaneously had an orgasm that had lasted on and off for nearly two hours.

(Now that’s a prescription.)

But the scandal here — the lurid, eyeball-drawing scandal — is that the numbers who suffer from sexual side effects due to anti-depressants have been played down and under-researched.

Surely this subject screams for the Alex Kuczynski treatment?


38 Responses to “Worst Side Effect Ever: The ‘Pleasureless Orgasm’”

  1. […] Edwards, in his blog on the SSRI effect on libido, says: “According to Scientific American, close to 10% of Americans […]

  2. Paul Says:

    I have been very frustrated with the orgasm that doesn’t feel good. It is really depressing and it happens all the time. Should I try a different anti-depressant?

    • James Says:

      I have found the complete opposite. I have found that they are much more intense and I never leave my wife alone now. She has noticed this too. I’m lucky that she doesn’t seem to mind 😛

      I started them about 6 weeks ago (Paxil 10mg).

      I’m 26 years old.

  3. jake Says:

    do not try another antidepressant. the ONLY long-term solution to the sexual side effects is to stop all antidepressants permanently.

  4. They force a normalization of the chemicals in the brain. And that includes the chemicals that make you feel good during orgasm. I know it sucks, but you can do things to make it better. For one, only have sex or masturbate when the pills should be wearing off. If you take a once-a-day pill in the morning, only do it at night or early in the morning before your next pill.

    If it really bothers you talk to your doctor. I was on mood stabilizers for a long time and was unable to reach orgasm while on them, but as soon as I was weaned off I started having orgasms. (I was losing my health insurance in the US because I was moving to Canada, and I don’t yet qualify for healthcare because my residency paperwork is still being processed, so I had to be weaned off the meds.)

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  11. anguisette Says:

    Paul, have you tried Wellbutrin (bupropion)? It’s a dopamine reuptake inhibitor rather than an SSRI and can actually have the effect of increasing libido, unlike the majority of antidepressants. I’ve been taking it for about two years (after trying several other antidepressants) and have been so happy I’ve finally found something that works that doesn’t also have horrible side effects (although obviously this will vary from person to person). It’s horrible that people are having to choose between managing their depression and being sexually fulfilled. I think that psychiatrists are incredibly remiss in not taking sexual side effects more seriously.

  12. Matt Says:

    Pleasureless orgasms (ejaculatory anhedonia) is not only caused by SSRIs. I have had it as long as I can remember–without ever having taken meds, anti-depressants, other psychoactives, or anything.

  13. Circe12 Says:

    Ignoring the spam on this thread, the key piece of information has got lost in translation, which is that the sexual side-effects of SSRIs can continue for an indefinite period. I don’t know if anyone has any information about reversing this–as I understand it the damage may be to the nerves or even DNA and may be irreversible.

  14. Rachael Says:

    Circe12 – I was on SSRIs for just 6 months two years ago, and I’ve never recovered from what they did to my sex drive. I used to orgasm after a few minutes, now it’s 40minutes and the orgasm is pleasureless. I’d also love to know how to reverse the side effects.

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  18. David Says:

    I have been very frustrated with the orgasm that doesn’t feel good. It is really depressing and it happens all the time. Should I try a different anti-depressant?

  19. Now this is what scared me most, “…close to 10% of Americans are on antidepressants. Let’s make it easy and say that’s 30 million of 300 million yanks”

    Do you understand what mean? A huge number of population are not happy; not living their fullest life possible!?

    You see, the big pharmaceutical firms are killing us gradually while smiling to the banks. Unfortunately, we keep blogging about this, but the Media won’t fight as much as they should the Big Pharma spends millions of dollars on advertising and sponsorship.

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  25. Lee-Anne Somerton Says:

    I was in the psychiatric system for many years. All the medications prescribed made,me physically and emitionaly suck. Psychiatry kills people through false diagnosis and,medication. It is evil and supported by evil drug companies. In the name of profit in the capitalist society. Psychiatry and medication should be named like guns. They both represent the collective conscious and unconscious of evil. Psychotherapy is the only way to recover from stress from which all emotional sickness emanates.

  26. aoeu Says:

    Been off Zoloft for 2 years, after only having been on it 1.5, and I still have genital anaesthesia…

    I’ve heard that Wellbutrin may counteract the effect… but it’s contraindicated in individuals with epilepsy, which I have.

    This f***ing sucks.

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  31. Edward Darrell Irwin II Says:

    I’ve been on Zoloft for 3 months & have had the desensitization & pleasureless orgasm. Since the 2nd week; I figured it would pass, but hasn’t. I see my doctor next week.

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