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An Integrative Approach to Sexual Side Effects in Psychiatry

At Driftless Integrative Psychiatry, it's not uncommon for patients to bring up sexual concerns. These subjects, often viewed as taboo, can have a significant impact on one's overall wellbeing, even if they are sometimes difficult to discuss in the confidential setting of a psychiatrist's or therapist's office.

Unraveling the Complexity of Sexual Health Issues

Sexual issues are multifaceted. Understanding the root of these concerns requires thorough patient history and an in-depth exploration of whether the cause is psychological, cultural, medical, or perhaps a combination of these factors.

Key questions to consider include: How are the patient's relationships? Is it a desire issue or an anatomical one? Are they experiencing menopause? What are their beliefs about sex? The answers to these queries provide invaluable context for addressing sexual health issues.

Moreover, open and empathetic discussions about any underlying abuse or trauma are crucial. These conversations can pave the way for patients to build safety and trust within themselves, and referral to specialized trauma-focused therapists may be beneficial.

Navigating Antidepressants and Sexual Health

A prevalent concern in psychiatric medication use, especially antidepressants like SSRIs (Selective Serotonin Reuptake Inhibitors), is their potential sexual side effects. Patients often struggle with these side effects, believing they must accept them as an unavoidable trade-off for mental health. However, this belief isn't accurate.

Educating patients about the common occurrence of sexual side effects related to psychiatric medications is vital. Reassuring them that prioritizing their sexual health is not only legitimate but necessary is equally important.

Exploring Medication Options

If a patient experiences sexual side effects from an SSRI, several strategies can be explored:

  1. Try another SSRI: A significant percentage of patients on SSRIs report sexual issues, but this risk doesn't necessarily translate to all SSRIs. Trying a different SSRI could be an option if the patient wishes to continue with conventional antidepressant treatment.

  2. Switch to a different class of psychiatric medications: Certain medications for anxiety or depression are less likely to cause sexual side effects. These include Vilazodone (Viibryd), Pristiq, and Vortioxetine (Trintellix). Other options like Mirtazapine and Wellbutrin, while more affordable, may have their unique set of side effects.

  3. Non-Medication Approaches: Assisting the patient in gradually reducing the use of an antidepressant might be beneficial. Explore other treatments for depression/anxiety such as dietary modifications (like the Mediterranean diet), exercise, psychotherapy, vagus nerve toning practices, and the use of supplements or herbal remedies.

Augmenting Treatment for Sexual Side Effects

If a patient wishes to continue their antidepressant because it's effective, certain supplements can help manage the sexual side effects:

  • Maca: This root vegetable from Peru has been traditionally used for its energy-boosting and libido-enhancing properties.

  • Wellbutrin: This antidepressant has fewer sexual side effects compared to SSRIs and can be used in combination with the patient's current medication.

  • Saffron: Known as an aphrodisiac, this spice has a rich history in traditional medicine for treating sexual dysfunction.

  • L-arginine: This amino acid helps improve blood flow, potentially improving arousal and orgasm issues.

At Driftless Integrative Psychiatry, we maintain open dialogues with our patients about all aspects of their lives, including their sexual health. This comprehensive approach allows us to consider all facets of their well-being. Remember, prioritizing your sexual health is not only valid but a crucial part of your mental health journey.

This blog post is intended to be informative and does not replace individual medical advice. Always consult with your healthcare provider or a professional for any personal medical decisions or concerns you may have. Everyone's health situation is unique and should be evaluated by a healthcare professional. As we move forward, we'll continue exploring various approaches to managing anxiety, depression, and related concerns.


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