What Happened to My Sex Life? (cont.)

SSRIs are the current drugs of choice for treating depression, and the most popular still is Prozac. At $2.6 billion, Prozac, which costs about $90 a month, has the third-best annual sales of any pharmaceutical sold in the United States, according to market research firm IMS Health.

Such drugs may be great for prisoners, priests, and recovering nymphomaniacs. But what about the rest of us?

Claire, a 46-year-old writer from Detroit, is a case in point. Before Claire got married 20 years ago, she prided herself on her libertine ways. At any given moment, Claire would have three or four lovers stashed away. Sex was Claire's middle name.

Because of health-related problems and difficulties at her job, Claire started taking Paxil four years ago. "I was totally stressed out. I was in tears every day. Everything seemed too much to handle. No small thing was too small to set me off. I felt I was in a tornado continually sucking me down. If I snagged my sweater on barbed wire, I'd be unable to get free. I'd stay snared for days or weeks. Paxil was terrific. But no one warned me about the side effects -- although, really, it didn't matter because suddenly there was peace, some days I wasn't in tears. And soon, I never felt the need to cry."

The cost: Claire's libido -- which had been such a central part of her life -- diminished and then dried up. She and her husband, with whom she was still deeply in love, ceased to have sex with any regularity. They had become their parents; sex was reserved for special occasions, like their anniversary night.

Still, Claire was feeling so great on the antidepressant that in the summer of 1998, she thought she could go it alone ("A little voice inside me said I didn't need to rely on a drug any longer ..."), so she started cutting back on the Paxil and within weeks her libido kicked back in. This was the old Claire.

Alas, by late winter, Claire was back to weeping every day, not sleeping, not eating. "My sex drive may have come back, but in that condition I wasn't interested. I didn't want to go on Paxil again. It had caused me to have night sweats and my heart would race. So, when I returned to my psychiatrist, he suggested Celexa, but warned me about the sexual side effects."

" 'Start me on whatever is going to work the fastest,' I told him, and my husband (who was in the waiting room) agreed."

Unlike Paxil, Celexa didn't cause the weird side effects in Claire. Her outlook on life became rosy again. But, again, the drug did a number on Claire's libido -- and still does. "It's not as though I don't want to cuddle or kiss. It's just that my genitalia aren't aroused -- but with the drug, nothing is easily aroused. We probably have sex once or twice a week. But I don't initiate it. I initiate it intellectually and psychologically, but for me it always can wait. I love my husband and I want to connect, but it always can wait till tomorrow."