Did you know premature ejaculation is the most common sexual disorder among males affecting upto 30-40% of the male population worldwide (1)?
Men usually tend to hide their sexual problems because of societal pressure and the stigma related to sexual dysfunction. As a result they may turn to unhealthy coping mechanisms like smoking or drinking.
There are drugs available that can treat this sexual problem in men with high efficacy. This treatment drug is called citalopram (Celexa®). However, the hidden cost of this happiness for men is significant due to its side effects.
Today, we will see what Celexa (citalopram) is, how it works for premature ejaculation, what are its potential side effects, and how to deal with these side effects.
Celexa (citalopram hydrobromide) is a selective serotonin reuptake inhibitor (SSRI) that helps by affecting certain chemicals in the brain. It is officially approved to treat major depressive disorder (MDD).
Sometimes, doctors also prescribe citalopram for other conditions, even though it hasn’t been officially approved for them.
These conditions include:
But it is calledthe “off-label” use, meaning the FDA hasn’t officially approved for these conditions. Your doctor should explain why they recommend it and discuss other treatment options with you as well.
A placebo-controlled study was conducted among 26 married males diagnosed with premature ejaculation. 13 of them were given citalopram and all of them reported improved ejaculation latency and sexual experience (2).
But how does celexa treat premature ejaculation?
Research says serotonin levels regulate ejaculatory response in males (3). Serotonin is a hormone that controls your mood, wakefulness, well-being, and sexual desire. When your serotonin is normal, you feel focused, stable, happy, and calm. If it’s low, you might feel depressed. Moreover, low serotonin levels cause premature ejaculation in males as well.
Celexa, as the name suggests blocks serotonin reuptake and increases its levels in the brain, which can help alleviate symptoms of depression and anxiety and delay the ejaculation time.
Apart from the benefits, Celexa causes some unwanted sexual side effects. These can include reduced sexual desire, delayed or absent orgasm, and difficulty achieving or maintaining an erection (erectile dysfunction). Around 25-30% of the SSRI’s users experience these problems (4).
The exact mechanism is not fully understood, but it is believed that the increased serotonin levels caused by Celexa can interfere with the normal functioning of the sexual response. It can disrupt the expected levels of testosterone and dopamine, leading to low sex drive.
The sexual side effects, like having less interest in sex and trouble reaching orgasm, can happen to both men and women taking Celexa.
No. Most people find that their sexual function improves over time after they stop taking the antidepressant. However, for some, the sexual side effects might stick around for months or even years after stopping the medication (5).
Other possible side effects of Celexa include:
When Celexa users experience its side effects, especially sexual problems, the very first thought they have is to stop taking the medicine.
A case study was reported by David E. Adson in 2003 in which a man who was taking SSRI (Citalopram/Celexa) for his depression stopped taking the drug. Within 4-5 days, he started experiencing premature ejaculation, and orgasm was achieved within 1 minute. This situation continued even after restarting the Citalopram/Celexa treatment (6).
Moreover, males are usually reluctant to report such side effects to their doctor, but you have to trust your doctor and never stop or restart any medication by yourself. Talk to your doctor, discuss your concerns, and get treated.
If the sexual side effects of Celexa are too much for you to handle, stopping the medicine abruptly is never the solution. Instead, try these tips:
A 2019 meta-analysis concluded that antidepressants when taken in lower quantities, have the best efficacy and reduced side effects (7).
In most people, the side effects of Celexa are fixed by lowering the dose of the drug.
If even lowering the dose does not reduce the side effects, you can always get another antidepressant.
Now, the problem is you cannot just switch to another drug; this quick withdrawal of Celexa will cause premature ejaculation.
Your doctor will “taper your dose,” which means gradually lowering the dose of the first drug day by day and similarly increasing the dose of the new drug daily.
Evidence also suggests that taking sexual dysfunction drugs like Sildenafil (Viagra®) along with the antidepressant can also help (8).
Your medicine might cause more potent side effects at certain times of the day, like shortly after you take it. If that happens, you could try planning intimacy when the side effects bother you less or take the medicine at a different time.
Getting intimate, when the levels of Celexa in your body are the lowest, is a clever idea so it does not affect your sexual life.
Consider taking a break from your medication. Depending on how long it stays in your body, you could pause taking it for a few days, like before a weekend when you plan to be intimate. This isn’t spontaneous, but it can help if you carefully follow your doctor’s advice on how to stop and start your medicine again.
But always talk to your doctor or therapist first before doing this. It could cause problems, especially if it’s a medication that leaves your body quickly.
Therapy can be beneficial for mental health issues and has fewer side effects than medication.
It can also help deal with the sexual side effects of Celexa. Talking about these issues with your partner can make you feel better, too.
Drink plenty of water, take warm baths, and exercise regularly. Some natural remedies can also help with anxiety, which might improve your symptoms.
Both Celexa and Citalopram are FDA-approved medicines for depression. Here, we will see the differences between the two drugs.
| Category | Citalopram | Escitalopram |
| Brand names | Celexa | Lexapro |
| Treatment | FDA-approved for treating major depressive disorder (MDD) | FDA-approved for treating major depressive disorder (MDD) and generalized anxiety disorder (GAD) |
| Dose form | Oral tablets are available | Available in both tablet and solution form |
| Recommended dosage | 20mg dose per day | 10mg dose per day |
| Who can use it? | Adults only | Adolescents of 12+ age and adults |
| Major side effects | Sexual dysfunction, heart problems at high doses | Sexual dysfunction, sleep disturbances, and taste changes |
| Active ingredient | R-citalopram and S-citalopram | S-citalopram |
| Withdrawal symptoms | Yes | Yes |
Celexa is an antidepressant medication that works by increasing serotonin levels in the brain. It is widely used for treating depression and anxiety. However, its potential side effects include sexual dysfunction that can affect the quality of life in men. Open communication with a healthcare provider is vital to finding the right treatment balance.
References
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