I'm worried about the sexual side effects from antidepressants. What can be done to prevent or reduce such side effects?

Answer From Daniel K. Hall-Flavin, M.D.

Sexual side effects are common with antidepressants in both men and women, so your concern is understandable. Effects on sexual function can include:

  • A change in your desire for sex
  • Erectile problems
  • Orgasm problems
  • Problems with arousal, comfort and satisfaction

The severity of sexual side effects depends on the individual and the specific type and dose of antidepressant. For some people, sexual side effects are minor or may ease up as their bodies adjust to the medication. For others, sexual side effects continue to be a problem.

Antidepressants with the lowest rate of sexual side effects include:

  • Bupropion (Wellbutrin XL, Wellbutrin SR)
  • Mirtazapine (Remeron)
  • Vilazodone (Viibryd)
  • Vortioxetine (Trintellix)

Antidepressants most likely to cause sexual side effects include:

  • Selective serotonin reuptake inhibitors (SSRIs), which include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs), which include venlafaxine (Effexor XR), desvenlafaxine (Pristiq) and duloxetine (Cymbalta).
  • Tricyclic and tetracyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and clomipramine (Anafranil).
  • Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate). However, selegiline (Emsam), an MAOI that you stick on your skin as a patch, has a low risk of sexual side effects.

If you're taking an antidepressant that causes sexual side effects, your doctor may recommend one or more of these strategies:

  • Waiting several weeks to see whether sexual side effects get better.
  • Adjusting the dose of your antidepressant to reduce the risk of sexual side effects. But always talk with your doctor before changing your dose.
  • Switching to another antidepressant that may be less likely to cause sexual side effects.
  • Adding a second antidepressant or another type of medication to counter sexual side effects. For example, the addition of the antidepressant bupropion may ease sexual side effects caused by another antidepressant.
  • Adding a medication to improve sexual function, such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra, Staxyn). These medications are approved by the Food and Drug Administration only to treat sexual problems in men. Limited research suggests that sildenafil may improve sexual problems caused by antidepressants in some women, but more information is needed on its effectiveness and safety in women.

Stopping medication because of sexual side effects is a common problem, and for most people this means depression returns. Work with your doctor to find an effective antidepressant or combination of medications that will reduce your sexual side effects and keep your depression under control.

If you're pregnant or trying to become pregnant, tell your doctor, as this may affect the type of antidepressant that's appropriate.

Be patient. Everyone reacts differently to antidepressants, so it may take some trial and error to identify what works best for you.

Jan. 25, 2020 See more Expert Answers

See also

  1. MIND diet may cut Alzheimer's risk
  2. Addison's disease
  3. Adjustment disorders
  4. Adrenal fatigue: What causes it?
  5. After a flood, are food and medicines safe to use?
  6. Alzheimer's: New treatments
  7. Alzheimer's 101
  8. Caregiver depression
  9. Understanding the difference between dementia types
  10. Alzheimer's: Can a head injury increase my risk?
  11. Mediterranean diet
  12. Alzheimer's disease
  13. Alzheimer's disease: Can exercise prevent memory loss?
  14. Alzheimer's drugs
  15. Alzheimer's genes
  16. Alzheimer's nose spray: New Alzheimer's treatment?
  17. Alzheimer's or depression: Could it be both?
  18. Alzheimer's prevention: Does it exist?
  19. Alzheimer's stages
  20. Alzheimer's test: Detection at the earliest stages
  21. Ambien: Is dependence a concern?
  22. Antidepressant withdrawal: Is there such a thing?
  23. Antidepressants and alcohol: What's the concern?
  24. Antidepressants and weight gain: What causes it?
  25. Antidepressants: Can they stop working?
  26. Antidepressants: Side effects
  27. Antidepressants: Selecting one that's right for you
  28. Antiphospholipid syndrome
  29. Antidepressants and pregnancy
  30. Atypical antidepressants
  31. Atypical depression
  32. Axona: Medical food to treat Alzheimer's
  33. Back pain
  34. Bedtime routines: Not just for babies
  35. Benefits of being bilingual
  36. Binge-eating disorder
  37. Blood Basics
  38. Borderline personality disorder
  39. Breast-feeding and medications
  40. Dr. Wallace Video
  41. Parathyroid
  42. Caffeine and depression: Is there a link?
  43. The role of diet and exercise in preventing Alzheimer's disease
  44. Can music help someone with Alzheimer's?
  45. Can zinc supplements help treat hidradenitis suppurativa?
  46. Can't sleep? Try daytime exercise
  47. Hidradenitis suppurativa wound care
  48. Celiac disease
  49. Celiac disease: Can gluten be absorbed through the skin?
  50. Celiac disease diet: How do I get enough grains?
  51. Chase away the winter blues
  52. Child abuse
  53. Chronic traumatic encephalopathy
  54. CJD - Creutzfeldt-Jakob Disease
  55. Clinical depression: What does that mean?
  56. Clinical trials for hidradenitis suppurativa
  57. Coconut oil: Can it cure hypothyroidism?
  58. Coffee after dinner? Make it decaf
  59. Complete blood count (CBC)
  60. Complicated grief
  61. Compulsive sexual behavior
  62. Concussion
  63. Concussion in children
  64. Concussion Recovery
  65. Concussion Telemedicine
  66. Coping with the stress of hidradenitis suppurativa
  67. Coping with the emotional ups and downs of psoriatic arthritis
  68. COVID-19 and your mental health
  69. Coping with unemployment caused by COVID-19
  70. Creating a hidradenitis suppurativa care team
  71. Creutzfeldt-Jakob disease
  72. Cupping therapy: Can it relieve fibromyalgia pain?
  73. Cushing syndrome
  74. Cyclothymia (cyclothymic disorder)
  75. Delirium
  76. Depression and anxiety: Can I have both?
  77. Depression, anxiety and exercise
  78. Depression: Diagnosis is key
  79. Depression during pregnancy
  80. Depression in women: Understanding the gender gap
  81. Depression (major depressive disorder)
  82. Depression: Provide support, encouragement
  83. Depression: Supporting a family member or friend
  84. Diabetes and depression: Coping with the two conditions
  85. Diagnosing Alzheimer's
  86. Dissociative disorders
  87. Vitamin C and mood
  88. Drug addiction (substance use disorder)
  89. Alzheimer's elder care
  90. Electroconvulsive therapy (ECT)
  91. Empty nest syndrome
  92. Fatigue
  93. Fibromyalgia
  94. Fibromyalgia or not?
  95. Fibromyalgia and acupuncture
  96. Fibromyalgia: Does exercise help or hurt?
  97. Fibromyalgia: Linked to other health problems?
  98. Fibromyalgia pain: Options for coping
  99. Fibromyalgia: Self-care tips
  100. Fibromyalgia and Neurontin
  101. Fish oil and depression
  102. Folic acid supplements: Can they slow cognitive decline?
  103. Foods and sleep
  104. Ginkgo biloba: Can it prevent memory loss?
  105. Global Bridges
  106. HABIT program orientation
  107. Hangover prevention: Do lighter colored drinks help?
  108. Hangovers
  109. Hashimoto's disease
  110. Headache
  111. Hidradenitis suppurativa
  112. Hidradenitis suppurativa and biologics: Get the facts
  113. Hidradenitis suppurativa and diet: What's recommended?
  114. Hidradenitis suppurativa: Tips for weight-loss success
  115. Hidradenitis suppurativa: What is it?
  116. Hidradenitis suppurativa: When does it appear?
  117. How opioid addiction occurs
  118. How to tell if a loved one is abusing opioids
  119. How to use opioids safely
  120. Huperzine A: Can it treat Alzheimer's?
  121. Hyperparathyroidism
  122. Hypoparathyroidism
  123. Hypothyroidism: Can calcium supplements interfere with treatment?
  124. Hypothyroidism diet
  125. Hypothyroidism and joint pain?
  126. Hypothyroidism: Should I take iodine supplements?
  127. Hypothyroidism symptoms: Can hypothyroidism cause eye problems?
  128. Hypothyroidism
  129. Insomnia
  130. Insomnia: How do I stay asleep?
  131. Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills
  132. Intervention: Help a loved one overcome addiction
  133. Is depression a factor in rheumatoid arthritis?
  134. Is fibromyalgia hereditary?
  135. Is the definition of Alzheimer's disease changing?
  136. Depression and diet
  137. Kratom for opioid withdrawal
  138. Lack of sleep: Can it make you sick?
  139. Lexapro side effects: Is breast tenderness common?
  140. Living better with hidradenitis suppurativa
  141. Low blood pressure (hypotension)
  142. Male depression: Understanding the issues
  143. Managing depression in MS
  144. Managing Headaches
  145. Managing hidradenitis suppurativa: Early treatment is crucial
  146. Hidradenitis suppurativa-related health risks
  147. MAOIs and diet: Is it necessary to restrict tyramine?
  148. Marijuana and depression
  149. Mayo Clinic Minute: 3 tips to reduce your risk of Alzheimer's disease
  150. Mayo Clinic Minute: Alzheimer's disease risk and lifestyle
  151. Mayo Clinic Minute New definition of Alzheimer's changes
  152. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  153. Mayo Clinic Minute Weathering migraines
  154. Mayo Clinic Minute: Women and Alzheimer's Disease
  155. Medication overuse headaches
  156. Meditation
  157. Mediterranean diet recipes
  158. Memory loss: When to seek help
  159. Mental health: Overcoming the stigma of mental illness
  160. Mental health providers: Tips on finding one
  161. Mental health
  162. Mental illness
  163. Migraine
  164. Migraine medications and antidepressants
  165. Migraine treatment: Can antidepressants help?
  166. Infographic: Migraine Treatments: Botox & Nerve Blocking
  167. Migraines and gastrointestinal problems: Is there a link?
  168. Migraines and Vertigo
  169. Migraines: Are they triggered by weather changes?
  170. Alleviating migraine pain
  171. Mild cognitive impairment (MCI)
  172. Mild depression: Are antidepressants effective?
  173. Mindfulness exercises
  174. Monoamine oxidase inhibitors (MAOIs)
  175. Natural remedies for depression: Are they effective?
  176. Nervous breakdown: What does it mean?
  177. New Alzheimers Research
  178. Nicotine dependence
  179. Not tired? Don't go to bed
  180. Occipital nerve stimulation: Effective migraine treatment?
  181. Ocular migraine: When to seek help
  182. Opioids and other drugs: What to watch for
  183. Oppositional defiant disorder (ODD)
  184. Pain and depression: Is there a link?
  185. Pancreatic cancer
  186. Infographic: Pancreatic Cancer: Minimally Invasive Surgery
  187. Pancreatic Cancer Survivor
  188. Pancreatic cancer treatment: Why is it so challenging?
  189. Infographic: Pancreatic Cancers-Whipple
  190. Perimenopause
  191. Perimenopause birth control options
  192. Pet therapy
  193. Phosphatidylserine supplements: Can they improve memory?
  194. Pituitary tumors
  195. Polymyalgia rheumatica
  196. Premenstrual dysphoric disorder
  197. Premenstrual syndrome (PMS)
  198. Prescription drug abuse
  199. Prescription sleeping pills: What's right for you?
  200. Progressive supranuclear palsy
  201. Psychotherapy
  202. Rapidly progressing Alzheimer's: Something else?
  203. Reducing the discomfort of hidradenitis suppurativa: Self-care tips
  204. Salt craving: A symptom of Addison's disease?
  205. Savella may help fatigue
  206. Schizoaffective disorder
  207. Seasonal affective disorder (SAD)
  208. Choosing a light box
  209. Selective serotonin reuptake inhibitors (SSRIs)
  210. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  211. Skip booze for better sleep
  212. Sleep disorders
  213. Sleep tips
  214. Smoking and rheumatoid arthritis: What's the risk?
  215. Soy: Does it worsen hypothyroidism?
  216. Staying active with hidradenitis suppurativa
  217. Stop your next migraine before it starts
  218. Stress symptoms
  219. Sundowning: Late-day confusion
  220. Support groups
  221. Surgery for hidradenitis suppurativa
  222. Symptom Checker
  223. Tapering off opioids: When and how
  224. Tinnitus and antidepressants
  225. Transcranial magnetic stimulation
  226. Traumatic brain injury
  227. Treating hidradenitis suppurativa: Explore your options
  228. Treating hidradenitis suppurativa with antibiotics and hormones
  229. Treating pain: When is an opioid the right choice?
  230. Treatment-resistant depression
  231. Tricyclic antidepressants and tetracyclic antidepressants
  232. Unexplained weight loss
  233. Vagus nerve stimulation
  234. Valerian: A safe and effective herbal sleep aid?
  235. Vascular dementia
  236. Video: Alzheimer's drug shows early promise
  237. Video: Vagus nerve stimulation
  238. Vitamin B-12 and depression
  239. Vitamin B-12 and Alzheimer's
  240. Vitamin D: Can it prevent Alzheimer's & dementia?
  241. What are opioids and why are they dangerous?
  242. What are the signs and symptoms of hidradenitis suppurativa?
  243. What is reflexology?
  244. Wilson's disease
  245. Wilson's syndrome: An accepted medical diagnosis?
  246. Young-onset Alzheimer's