Question:

If you take a lot of psychiatric medication, like zoloft or prozac, will it affect my sex drive?

Answer:

Zoloft and Prozac fall under the category of Selective Serotonin Reuptake inhibitors.  SSRI’s as a group have been associated with sexual side effects.  There is no way to tell if one agent will necessarily cause it while a different agent won’t.  The only way to know if you will or will not have sexual side effects if to have a trial of a given medication.  It will be critical to monitor and communicate any sexual side effects that you may experience with your prescribing physician. If sexual side effects present they usually present as ejaculatory dysfunction and/or decreased libido.

When thinking about if one should take a medication or not based on possible side effects, I think it becomes about close evaluation of the risk to benefit ratio.  If the benefits out weigh the risks (i.e. side effects) and if the individual is willing to accept them, then it may be appropriate to continue the medication as prescribed under the guidance of your physician.  Of course, if other medications are available, one could be put on a trial of a different medication to determine how well it is tolerated..

Remember to always communicate to your physician about side effects that you may be experiencing (sexual or any other) to determine the best course of action..

Question:

My primary care doctor prescribed Prozac for me but I am afraid to take it. What are the side effects that I should be worried about when taking this medication?

Answer:

Prozac belongs to a class of medications that are based on their mechanism of action; medications belonging to this class are called selective serotonin re-uptake inhibitor’s or and SSRI’s; low serotonin levels in the brain are thought to play a significant role in mood and anxiety disorders; this group of medications increase serotonin levels in the brain by selectively inhibiting the uptake of serotonin after it has been released; bottom line, serotonin levels are increased which in turn is correlated to an improvement in symptoms related to depression and anxiety disorders.

The most common side effects of this class are:

• Allergic or Toxic — Rash, Pruritus (skin inflammation)
• Neurological — Headache, Tremor, Dizziness, Asthenia
• Behavioral — Insomnia, Anxiety, Nervousness, Agitation, Abnormal dreams, Drowsiness and fatigue
• Autonomic — Excessive sweating
• Gastrointestinal — Nausea, Disturbances of appetite, Diarrhea
• Respiratory — Bronchitis, Rhinitis (inflammation of the nasal mucous membranes), Yawning
• Endocrine — Weight loss
• Musculoskeletal — Muscle pain, Back pain, Joint pain
• Urogenital — Painful menstruation, Sexual dysfunction, Urinary tract infection, Frequent micturition
• Miscellaneous – Chills

Keep in mind that not all SSRI’s cause all the above side effects and that different individuals respond differently to different SSRI’s; your doctor and you have to work together to see which medication suits you the best; always check with your doctor if you have any side effects (symptoms that were not present prior to starting a particular medication) and ask him or her if other options are available; also, keep a small journal of how you feel when starting any new medication; note down any changes in mood, appetite or energy; be sure to bring your notes to your visits with your physician; make sure to address your questions during your follow up visits; don’t be afraid to ask questions related to your working diagnoses and treatment plan; you have a right to ask questions of your health care providers and deserve answers if they are known; Lastly, only take prescription medications under the supervision of a physician. Take care of your self and keep the lines of communication open.