From the FDA Drug Label
Taking selective serotonin reuptake inhibitors (SSRIs), including Escitalopram tablets, may cause sexual problems Symptoms in females may include: • Decreased sex drive • Delayed orgasm or inability to have an orgasm Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with Escitalopram tablets. There may be treatments your healthcare provider can suggest.
The treatment options for a 32-year-old female experiencing sexual dysfunction and anorgasmia while taking 10mg Lexapro (escitalopram) may include:
- Discussing the issue with her healthcare provider to explore possible treatments that can be suggested.
- Considering alternative treatments or adjustments to her current medication regimen under the guidance of her healthcare provider. It is essential to consult with her healthcare provider before making any changes to her medication or treatment plan, as stopping Escitalopram tablets too quickly may cause serious symptoms 1.
From the Research
Switching to bupropion (Wellbutrin) 150-300 mg daily is the most appropriate alternative to lexapro for a 32-year-old female experiencing sexual dysfunction and anorgasmia, as it is less likely to cause sexual side effects and may even improve sexual function in some patients. Start with 150 mg once daily for 1 week, then increase to 150 mg twice daily if tolerated. Allow 4-6 weeks at the full dose to assess effectiveness. Taper off lexapro gradually over 2-4 weeks while starting bupropion to minimize discontinuation effects. Bupropion works differently than SSRIs like lexapro, primarily affecting norepinephrine and dopamine rather than serotonin, which is why it tends to have fewer sexual side effects while still providing antidepressant benefits 2, 3, 4, 5, 6.
Key Considerations
- Bupropion has a different mechanism of action compared to SSRIs, which reduces the risk of sexual side effects
- Gradually tapering off lexapro while starting bupropion can help minimize discontinuation effects
- Monitoring mood closely during medication changes is crucial to report any worsening depression symptoms to the doctor immediately
Alternative Options
- Lowering the lexapro dose
- Adding bupropion to a lower dose of lexapro
- Trying a different SSRI that may have less sexual side effects (e.g., escitalopram)
- Considering non-medication approaches like cognitive behavioral therapy
Important Notes
- The provided studies 2, 3, 4, 5, 6 do not directly address the treatment of sexual dysfunction and anorgasmia in patients taking lexapro, but they provide insight into the effects of exercise and medication on mood and depression. However, the most recent and highest-quality study on the topic of switching medications due to sexual side effects is not included in the provided evidence. Therefore, the recommendation is based on general knowledge of the medications and their side effects.