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But as with Claire, the drug nailed her sex life. "I remember initially on Prozac I had little interest in sex. It really was a nasty side effect. But it was a trade-off: Everything functioned so much more smoothly that I never got too concerned about what it was doing to my sex drive."

Also Today Prozac indignation How a little-known Harvard clinician needled sleeping giant Eli Lilly By Craig Offman At peace with Prozac The drug was my salvation. Does that make me a spiritual sloth? By Kelly Luker

With Holly -- who is 48, works out with a personal trainer every week and is engaged to remarry in the fall -- her libido gradually returned after about a year on the drug. Psychiatrists say some people neutralize the effect the drug has on their sex drive, but it can take months, sometimes years.

Holly noticed something else about the Prozac, something commonly known as "Prozac poop-out." The longer she took the drug, the less effective it seemed to become. In 1992, her gynecologist switched her to Paxil, but that seemed to deaden her much more than the Prozac did -- and not just her sex drive. "My emotions, reactions, feelings were numbed with the Paxil. Again, though, my sex drive came back but it took time, maybe a year."

Finally, two years ago, Holly went to a psychiatrist who prescribed Celexa. "For the first three weeks, I felt euphoric, almost giddy. Then I came down a little, but I don't feel deadened. I have back my emotions. It still has an negative effect on my sex drive, but at least it's the least of the three drugs."

Everywhere I turned, I heard the same story. The drugs were great, so great that they were worth giving up great sex for. Cassie, a pixieish, freckle-faced, 33-year-old Web site developer from San Francisco, told me that a crushing, traumatic divorce two years ago sent her crashing into a downward spiral, and Prozac was the only way out. She credits Prozac with saving her life. For the first year on the drug, her sex drive was minimal, but "who wants to have sex when you're trying to climb back to being yourself again?" In the last year, she said, her body seems to have compensated for the Prozac and her libido appears to be coming back, although she can't say for sure because she's not currently in a relationship.

When I canvassed my male friends on antidepressants about their sex lives, I got a different story. Either these guys are super studs and nothing can deaden their firm, erect ardor -- or maybe it was an Arnold Schwarzenegger macho-guy thing.

Greg, a 48-year-old television producer (and marathon runner) in Los Angeles, went on Prozac for depression in 1990, but developed chronic insomnia (a common side effect), so he switched to Zoloft a year later. Greg says he doesn't really know whether the SSRI has done anything to his sex drive. Now married and the father of a 2-year-old daughter, he says his interest in sex hasn't dampened, but his frequency is off from what it used to be. "I'm not prowling around as I did when I was 29." Still, Greg says he has no problem getting and keeping an erection, masturbating and fantasizing. That also might have something to do with his wife's travel schedule: She's away on business for up to two weeks at a time.

Another friend, Todd, a 41-year-old Manhattan media executive who is a drop-dead double for actor/playwright Sam Shepard, underwent a debilitating bout of depression while living overseas two years ago, so bad that he thought he'd have to be hospitalized. His psychiatrist prescribed Effexor, which gradually seemed to lift the dark clouds. Todd isn't sure about what sexual side effects the drug had on him. "I was so depressed, I didn't want to have sex. And with the Effexor, my mood got better, the depression eased, so I think, in that way, the drug probably helped me sexually." Todd weaned himself off the drug and now takes no antidepressants, and says he hasn't had a relapse.

It seems that in the trade-off between feeling blissed out and having orgasms, blissed out wins big. It used to be that anyone in the make-love-not-war generation would regale total strangers with the intimate details of their sex life -- blow jobs in movie theaters; mile-high-club trysts; threesomes in the backyard swimming pool. No one talked about money, except for how poor you were. Sex in all its multipositional glory was eminently worthy of conversation.

Welcome to the New Millennium, where the dot-com generation happily chats about IPOs, their nifty Palm VII handhelds and their accessory-dripping Lincoln Navigator SUVs. RAM size is what's important. Bandwidth is one's calling card. But mention orgasms, and the lattes go cold.

I'm not making light of depression. Surveys variously indicate that as many as 1 out of 3 women and 1 out of 8 men will, sometime during their lives, be classified as clinically depressed. And the World Health Organization says that by 2020, depression will top the list of health-related maladies in the developed world, and that severe depression will be the second-greatest cause of disability. It is a real disease; a crushing feeling that the world is closing in on you, that a thick black curtain is crashing down on your life.

Considering the enormous popularity of antidepressant drugs like Prozac, Paxil and Zoloft, and the drug culture that spawned them and now adores them, it makes sense that modern-day pharmacology has perfected such an effective and profitable pharmaceutical, which can pinpoint with awesome accuracy the neurotransmitters and receptor sites that cause depression.

The world's first SSRI, Prozac, was launched in 1986 in Belgium, and approved a year later for use in the United States. Since then, about 17 million Americans have taken the cream-and-lettuce-colored capsule. Prozac is the most widely prescribed antidepressant in the world.

Since its introduction, other drugs with similar properties have come down the pike: The most-widely known include Paxil, Zoloft, Luvox, Effexor and Celexa. Each is slightly different in its formulation and, therefore, affects users differently. Effexor, for instance, is not a straight SSRI; it blocks reuptake of not just serotonin, but also norepinephrine and dopamine.

A very short chemistry lesson on how SSRIs work and why they can massacre your sex drive: Higher levels of serotonin in the brain generally lead to enhanced moods. Prozac and its family of drugs increase the level of serotonin by preventing its uptake in receptor nerve cells, thereby assisting brain cells to communicate better with one another. For reasons not completely understood, the rush of serotonin causes in many people an effect that restores confidence, eases anxiety and improves self-esteem. The downside is that while the serotonin is doing all this great stuff, another chemical in the brain, dopamine -- known to increase sexual desire -- is suppressed.

Alas, the proposition was too good to be true. There is no free lunch. No rights to morning reveries of fellatio or sweet-dream send-offs of cunnilingus and a (legally) drug-induced feeling that makes you happy. If you want to be chemically induced confident and serene (or, at least, no longer depressed), you may have to kiss off such sexual luxuries once thought to be absolute generational rights.

As far as physicians (and anyone who's ever had sex before) can determine, there are four kinds of sexual dysfunction when it comes to SSRIs: loss of sexual desire, difficulty getting aroused (in men, erectile flaccidity; in women, lack of lubrication and similar lack of engorgement), duration of time from arousal to orgasm, and intensity and length of orgasm. Both women and men report about the same incidence of dysfunction when they take SSRIs.

But the incidence of dysfunction while on SSRIs probably is even greater than reported. The underlying problem is that physicians and patients often are too uptight to talk about the sexual side effects of antidepressants. Some patients are too embarrassed to fess up. Many are so happy that they're not depressed any longer that the dip in their sex lives becomes secondary to their spectacularly upturned mood. It's a price, but one that most SSRI-users happily pay.

Leave it to the world of fluorescent-tanned scientists to study just why SSRIs dampen sexual ardor. Three physicians at the University of Göteborg in Sweden (J. Matuszcyk Vega, K. Larsson and E. Eriksson) injected a male rat with fluoxetine (the chemical compound of Prozac), and the poor little guy couldn't ejaculate when he frequented a female rat nearby.

Fellows at the Department of Psychiatry and Neurosexology concocted another pioneering study at the Hague's Leyenburg Hospital. While having sex with their partners, volunteers equipped with stopwatches timed how long it took them to ejaculate while on SSRIs. The doctors concluded that the men's ejaculations were dramatically slowed, and in some cases, stopped by the SSRIs. Off the SSRIs, the men performed splendidly. I wonder where the men put the watch while they were pumping away.

It thus should come as no surprise that Prozac and other antidepressants of their ilk are extraordinarily effective when it comes to curing one sexual malady: premature ejaculation. The guy who used to come in five seconds before taking SSRIs can now last a manly 20 minutes.

Next page | There are ways to return your orgasms to 21-gun salutes