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Gabrielle J. Melin, M.D.
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Gabrielle J. Melin, M.D.
Gabrielle J. Melin, M.D.
Dr. Gabrielle Melin, board certified in general psychiatry and psychosomatic medicine, is looking for ways to empower patients and families dealing with chronic mental illness. She encourages patients to commit to working together with their physicians and health care teams.
Dr. Melin completed medical school at the University of Minnesota. She completed both her psychiatry residency and consultation-liaison fellowship at Mayo Clinic before joining the Mayo Clinic staff in 2001. She is medical director of Mayo Clinic Psychiatry Emergency Services in Rochester, Minn. She has special interests in emergency psychiatry, adult psychiatry and addiction psychiatry.
"Instilling hope is one of the most important things we can do for patients and families. Mental illness can be chronic and significantly impacts lives. Our goal is to provide the best treatment and education so that patients can manage their symptoms more effectively," she said.
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Depression blog
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July 31, 2008
Sexual dysfunction and antidepressants
By Gabrielle J. Melin, M.D.
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Sexual functioning can be affected by many things. Some of these factors include: past sexual experiences, religious beliefs, upbringing, self-esteem, medications (both psychiatric and non-psychiatric, such as some blood pressure medications), depression, and medical conditions such as diabetes or sleep apnea. Please don't stop any of your medications without talking with your doctor. There may be alternative medications you can use. This is by no means an exhaustive list, so talk with your doctor.
People can have difficulty with one or more of the phases of sexual functioning: desire, arousal and orgasm. Libido, or sex drive, may be reduced during a depressive episode. People describe not having interest in sex and in addition may not be able to have an orgasm. In order to achieve orgasm, arousal must occur. Some people can have low sex drive but are still able to become aroused and achieve orgasm.
A study just published this month in the "Journal of the American Medical Association" (JAMA) claims successful treatment of arousal and orgasm. This study was done on women only.
The study, an 8 week trial, included 98 women currently taking a serotonin reuptake inhibitor (SRI) anti-depressant medication. One-half took Viagra and the other half took a placebo. It showed that Viagra improved orgasm delay but not sexual desire, so will not help everyone. Viagra does have side effects, some of which can be very serious. No study is without bias. The number of women included is not a large number, so it is difficult to apply the results to the general population.
Also, the women's depression had to be in remission to be included in the study. So, was their sexual functioning improved because their depression was treated or was it because of the Viagra? Viagra needs to be taken one hour before sexual activity, so some feel that it reduces spontaneity.
As always, talk with your doctor about options if you have sexual dysfunction. Wellbutrin has a low incidence of sexual dysfunction as does Remeron. These both have potential side effects with Wellbutrin sometimes worsening anxiety and Remeron causing weight gain. Some people have sexual dysfunction with antidepressants such as Prozac, Paxil, Effexor, Cymbalta, Zoloft or Celexa, and some do not. We cannot predict who will have what side effect and to what degree at this time. We are learning more all the time, so stay tuned!
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