Sex Rx: Bupropion and your sex life

What it is most often prescribed for:

• Depression
• Manic-depressive disorder
• Smoking cessation, as part of a support program
• Attention deficit-hyperactivity disorder

How it works:

Bupropion increases the concentration of the neurotransmitter (brain chemical) dopamine. Dopamine increases drive and motivation, especially in the pursuit of pleasure; this is the main action through which bupropion helps to resolve depression, while also improving sexual functioning.

Possible sexual side effects:

Some antidepressant medications cause sexual dysfunction. Bupropion, however, has pro-sexual effects, and is often prescribed to counter the unpleasant sexual side effects of other antidepressants.

Bupropion improves the following:

• Low sex drive
• Sexual aversion
• Insufficient lubrication
• Erection difficulties
• Orgasmic difficulties

However, bupropion can aggravate the following conditions:

• Hypersexuality
• Painful ejaculation
• Amenorrhea

How bupropion affects sexual function:

It is not clear exactly how bupropion improves sexual function, but a few mechanisms are likely involved:

• Activation of the limbic system in the brain, an area that governs the generation or repression of sexual desire and response, including orgasm
• Increasing dopamine, a neurotransmitter believed to increase sexual drive and desire
• Stimulating DHEAS, a sex-related hormone that increases sexual desire

Contraindications

Bupropion should not be taken by people with a history of hypersexuality or menstrual disorders. Alternatives include:

• Fluoxetine (Prozac)
• Trazodone (Desyrel, Trazon, Trialodine)
• Nefazodone (Serzone)