MD here
All SSRI's (selective serotonin reuptake inhibitors) are known to produce delayed orgasm in 5 to 20 % of males. If one does, it is highly likely that it will occur with others too, as it is a class effect, although some may be more severe than others. If you fall into the 80 to 90% that don't you are lucky.
SSRI's include:
Fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin in Europe)
Paroxetine (Paxil, Seroxat, Aropax, Deroxat, Paroxat)
Sertraline (Zoloft, Lustral, Serlain)
Fluvoxamine(Luvox, Faverin)
Citalopram (Celexa, Cipramil, Emocal, Sepram, Seropram)
Escitalopram (Lexapro, Cipralex, Esertia)
Dapoxetine
Trazodone (atypical SRI)
SNRI's (serotonin-norepinephrine reuptake inhibitors) are also known to do the same thing as they are combined drugs of serotonin and norepinephrine pathways (so they are SSRI's with extra oomph.)
SNRI's include:
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Any drug that works on the serotonin system has delayed orgasm and decreased libido as possible side effects, so all the above have the same concerns.
Decreasing the dose may be of help, changing to a differnent drug MAY help (but unlikley).
The only real answer is to change the class of antidepressant to B[SIZE=-1]upropion[/SIZE] (Wellbutrin), which is not an SSRI or SNRI. In fact some doctors have found that ADDING Wellbutrin to the SSRI may help sexual function.
The other options include Tricyclic antidepressants (old drugs with multiple side-effects and quite dangerous), or MAOI's (Monoamine oxidase inhibitors which can be dangerous if taken with certain foods or drugs and alcohol) and St. John's Wort which is actually a naturally occuring MAOI. Due to potentially lethal dietary and drug interactions MAOI's had been reserved as a last line of defense.
(Whatever you do if you are taking St. John's Wort without consulting a doctor or naturopath you need to be extremely careful as it interacts with the same products as MAOI's and this can be life threatening.... and should also be a last line of defense!!)
So is Wellbutrin the answer....... not always.... it is often not as effective as SSRI's or SNRI's and has its own side effect profile.... including nightmares, and seizures. It is also stimulating and is not great for social anxiety disorder, generalized anxiety disorder, panic disorder, and people who have insomnia with their depression.
To answer the one retort.... most of us MD's don't just prescribe drugs unnecessarily.... only if someone really needs it. Counselling is a great mental health treatment, but is not always sufficient in cases with physical symptoms of depression.
So good luck to you, and all others.... once your depression is under control, you will likley come off your meds and be "normal" again....
If your depression is severe enough... an orgasm is not worth the weight in gold of feeling human and alive!!!
Keep smilin....
Rogue_MJ