The Pharma Sutra
For Prozac Nation, is dosage dictating desire?
July/August 1999
Miriam Karmel Feldman Utne Reader
One pill makes you taller, another makes you small. Or put more
prosaically: Have we reached the point where our most intimate
activities are governed not by our emotions but by the contents of
our medicine cabinets?
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With recent surveys indicating that more than half of those
taking Prozac and its relatives, Paxil and Zoloft, lack interest in
sex, have difficulty reaching orgasm, and are unable to maintain an
erection, depressed Americans are reaching for antidotes to their
antidotes, causing some observers to question our new commitment to
pharmacological sexuality.
'We want the quick pill. This is America,' says Dr. Domeena
Renshaw, author of Seven Weeks to Better Sex (Random House,
1995) and director of Loyola University's Sexual Dysfunction Clinic
in Chicago. But the problem doesn't stop at our borders. It exists
in all industrialized nations, where the clock and calendar have
become tyrants, she says. In our hurry-up society, sex becomes a
low priority. So we search for a quick, convenient, synthetic
stimulant to give us performance on demand. Women are even taking
their partners' Viagra, she notes.
When Prozac hit the market back in 1987, it spelled salvation
for millions of Americans battling clinical depression.
Psychiatrist Peter D. Kramer in his best-seller Listening to
Prozac (Viking, 1993) called the little pill a restorer of
self; it bestows feelings of greater self-worth, boosts confidence,
and improves job productivity. Today, Prozac is among the top five
prescribed drugs in the country.
But just as Prozac, Paxil, and Zoloft may make shy people more
comfortable in the boardroom, these selective serotonin reuptake
inhibitors (SSRIs) may have an altogether different effect in the
bedroom.
'When Prozac first came on the market, the medical profession
didn't have a clue about how vital serotonin was to sexual pleasure
and responsiveness,' writes Dr. Valerie Davis Raskin in Family
Therapy Networker (March/April 1999). As she explains it,
anti-depressants target neurotransmitters like serotonin inside and
outside the brain, and may reduce genital sensation as a mild
anesthetic would do. 'What used to feel great feels good, what used
to feel good feels OK, and what used to feel OK doesn't even
register now.' Remedies for these side effects include Viagra,
Wellbutrin, and gingko, she notes. And if that doesn't do it,
there's always Asian ginseng, oats, or wild yam, as Michael
Castleman points out in Herbs for Health (March/April
1999).