Since the anti-depressant medication Prozac first became widely used (and highly publicized), much has been written about the negative sexual side effects of SSRIs . Antidepressants that fall under this drug class, like Prozac, can cause sexual dysfunctions including inability to get an erection, loss of libido, and problems with orgasms.

A rarer, but notable, side effect has been documented in women and men who are taking SSRIs and other antidepressant medications -- spontaneous orgasms.

Spontaneous orgasms have been documented through a series of case studies published since the late 1980s. The clinicians have no single definition for spontaneous orgasm.

In some cases, its defined by the experience of orgasm (as reported by a patient) without sexual sensory stimulation and where there is no other physical explanation for why the individual is experiencing sexual excitement and climax. In one case study, a male patient described having a second orgasm following a “regular” orgasm that occurred when no stimulation was taking place.

The nature of the orgasms change from case to case, and the majority of published case studies are of women. In one, a woman reported orgasms that lasted a few minutes each time, four to five times a day. In another, a woman reported spontaneous orgasms occurring 10 to 15 times per day that each lasted less than a minute. Sometimes the orgasms are a result of non-sexual stimulation (vibration from riding a subway, sensation from a bowel movement), and other times no stimulation at all is reported.

Case studies have documented spontaneous orgasms as a side effect of antidepressant medications including:

• fluxotine (trade name: Prozac)
• paroxetine (trade name: Paxil)
• citalopram (trade name: Celexa)
• bupropion (trade name: Wellbutrin).

While the orgasms change from case to case, a clearer pattern of when they would occur surfaced in a 2005 paper on spontaneous orgasm in those taking paroxetine. Spontaneous orgasms occurred within the first few weeks of treatment and would cease quickly once treatment with paroxetine ended.

What Causes the Side Effect of Spontaneous Orgasms?

Researchers do not fully understand why some antidepressant treatments, particularly the SSRIs, can cause this rare side effect in some individuals. Most of the authors of the case studies agree that the cause has something to do with the neurotransmitter serotonin, a brain chemical. However, exactly what happens in the body to cause this hasn't been established. One of the most recent reviews of several case studies suggests that such a rare side effect is likely the result of many factors working together.

Some of the most commonly prescribed medications to treat depression are belong to a group of drugs referred to as selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing the levels of a neurotransmitter, serotonin, in the brain.

Unfortunately, serotonin has been found to have a negative impact on sexual arousal, desire, and orgasm, and many of the medications themselves--including Prozac, Zoloft, and Paxil-- commonly come with sexual dysfunction side effects, including:

• Decreased libido in men and women
• Erectile difficulties in men
• Inability to ejaculate
• Delayed or completely absent orgasms in men and women

Some physicians (and researchers) have examined the use of medications designed to enhance sexual performance (such as Viagra) in combination with SSRIs. While this might be a solution for you, it is probably a good first step to talk with your doctor and see if there are other possibilities before adding a new medication.

Other antidepressant medications that don’t belong to the SSRI family may have fewer sexual side effects. One study found that Wellbutrin, for example, has significantly fewer sexual side effects. The study was funded by the makers of Wellbutrin, although it's generally accepted amongst medical professionals that the drug has no significant sexual side effects. The drug may not, however, treat the same spectrum of mental health conditions as SSRIs--particularly primary anxiety disorders. Remeron, another antidepressant, also carries little in the way of sexual side effects.

In addition to trying to change the medication you are on, there are other ways to manage the sex effects of medication.