Antidepressants And Sex Drive: Libido Changes And Orgasm

Last Updated: June 3, 2020

Authored by Sharon Levy, MD, MPH

Reviewed by Daniel Hochman, MD

Antidepressants’ sexual side effects can impact patients’ quality of life, decrease self-esteem, affect relationships, and even force patients to stop the medication. That’s why people need to know it is normal and expected that they discuss sexual issues with a doctor before and after starting an antidepressant.

Side Effects In Men

Studies show that men experience slightly more sexual side effects than women, and that 40% of people who are under treatment with antidepressants will develop a form of sexual dysfunction at some point. Erectile dysfunction from antidepressants is actually the most common reason for discontinuing antidepressants. Other related symptoms are decreased interest in sex or the inability to reach an orgasm.

Other side effects include:

  • troubles with getting or maintaining an erection
  • painful erection
  • painful or delayed ejaculation

Side Effects In Women

Antidepressants can affect women in many of the same ways, with decreased libido or ability to achieve an orgasm. Other common sexual side effects in women include:

  • lactation that is not caused by breastfeeding or pregnancy
  • numbness in the nipples and vagina
  • discomfort during sex

Some antidepressants can also disrupt the menstrual cycle causing irregularities or changes in this process. Bupropion, Venlafaxine, and Fluoxetine can rarely cause menorrhagia (prolonged or heavy menstrual bleeding), while Bupropion might also cause menstrual spotting, shortened menstrual cycle, or the absence of menstruation.

Managing The Sexual Side Effects Of Antidepressants

From 700 patients that took part in a survey, 38% said they had experienced a reduced sex drive. But sex on antidepressants can be normal and enjoyable, and sexual dysfunction doesn’t have to be a permanent side effect.

There are various methods on how to increase libido while on antidepressants if the patient does not experience any improvement after a few months since the beginning of the treatment.

switching antidepressant drug

Switching Medication

If the side effects do not wear off in a few months since the beginning of the treatment, patients should feel comfortable asking their doctor to prescribe other medication, as different antidepressants have different side effects.

Lowering A Dosage

There is also the possibility of decreasing the current dosage if the patient feels the medication is effective but with bothersome side effects. The patient will be put on lower doses, and the progress will be monitored to decide which is the lowest dose the patient can take but still be effective.

Add a New Drug

Another solution to diminish the antidepressants sex drive side effects would be to add a drug that targets sexual dysfunction, such as Cialis, Wellbutrin, or Viagra. These drugs counter the sexual dysfunction induced by SSRIs and boost sexual response in both men and women.


For some patients, a sex therapist or a mental health professional can be helpful. Through therapy, patients can:

  • explore their sexual issues and concerns
  • find a bridge between antidepressants and relationships with their intimate partners
  • learn how to communicate their sexual needs
  • expand their sexual connection and sexual activities

Although it might take some time to find the right mix between psychotherapy and medication, this can help patients remain on an antidepressant and maintain a satisfying sex life.

couple managed antidepressants sexual side effects

Personal Changes

There are some personal changes that patients can do to work through antidepressants’ reduction of sex drive:

  • Foreplay. It takes an essential place in stimulating the mind and body and promote natural arousal. Allowing the body to go through the natural process that usually makes the person feel sexual arousal is important.
  • Have sex before taking that day’s dose of medication.
  • Reduce stress levels, get exercise, and get plenty of rest. Those can all boost levels of dopamine and sex drive.

Antidepressants Without Sexual Side Effects

For those who find that their current antidepressants negatively influence their sex life, there are better drug options with few or no sexual side effects.

pills in the bottle

Atypical Antidepressants

Atypical antidepressants are other options to consider for patients with major depression who experience intolerable side effects from SSRIs. Atypical antidepressants for major depression, such as Agomelatine, Bupropion, or Mirtazapine, are safe options for those who want to address sexual side effects of their current medication.

Tricyclic antidepressants (TCAs)

TCAs are one of the options to replace SSRIs. One of the most common tricyclic antidepressants is amitriptyline. The rate of amitriptyline-associated sexual dysfunction is lower compared to that of most other antidepressants.

Getting Help

Unfortunately, the sexual side effects of antidepressants are a reality that can severely affect patients’ quality of life. Some people experience sexual side effects and abruptly stop the medication, causing withdrawal symptoms and discontinuation of treatment. If depression goes untreated, risk of substance abuse is increased, leading some people to require specialized addiction centers and rehabs for substance treatment.

The best thing to do is remember that side effects from antidepressants are common and normal, so be comfortable talking about any concerns with your doctor. They can prescribe an adequate treatment plan aimed at avoiding these unpleasant side effects.

Page Sources

  1. Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug, Healthcare and Patient Safety. 2010; 2: 141–150. doi:10.2147/DHPS.S7634.
  2. Chen LW, Chen MY, Lian ZP, et al. Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice. American Journal of Men's Health. 2018; 12(2): 370–379. doi:10.1177/1557988317734519.
  3. Cascade E, Kalali AH, Kennedy SH. Real-World Data on SSRI Antidepressant Side Effects. Psychiatry (Edgmont). 2009; 6(2): 16–18.

Published on: October 15th, 2019

Updated on: June 3rd, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Daniel Hochman, MD

Dr. Daniel Hochman is a board certified Psychiatrist and leader in the field of addiction. He is the creator of a revolutionary online addiction recovery program, Dr. Hochman advocates for using strategies proven through hard science, and describes them in ways that are easy to understand and incorporate into one’s life. His treatment approach focuses on the underlying emotional causes of addiction to achieve a deep, lasting life change.


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