Antidepressants and sexual side effects
How common sexual side effects are, why they happen, and what can be done about them.
How common they are
Estimates vary widely depending on how the question is asked. By many measures, a third or more of people taking SSRIs or SNRIs notice some change in sexual function.
These effects are often underreported. People do not always bring them up, and clinicians do not always ask. That means the real number is probably higher than it looks in any single study. If you are experiencing this, you are not unusual, and it is a normal thing to discuss at an appointment.
What they can look like
Sexual side effects can take several forms. The most common are lower sex drive, delayed orgasm or difficulty reaching orgasm, difficulty with arousal, erectile difficulties, and reduced genital sensation.
They can affect anyone, regardless of sex or age. A person may notice one of these or several. They can also vary in how much they bother someone, which is part of why the conversation with a prescriber matters.
Why SSRIs and SNRIs cause them
SSRIs and SNRIs increase the activity of serotonin, a chemical messenger in the brain. Higher serotonin activity can dampen sexual response. The same mechanism that helps mood can affect this part of life.
There is an important nuance here. Depression and anxiety themselves also lower sex drive and sexual function. So sometimes treating the illness improves things, and at other times the medication is the cause. Sorting out which is which is a conversation with a prescriber, who can weigh the timing and the pattern.
What can be done
The key message is not to simply stop the medication. A prescriber can consider several options.
One is giving it some time. A minority of effects ease on their own, though many persist. Another is lowering the dose. Another is switching to a medication less likely to cause this. A prescriber may also add another medication. Bupropion, for example, is sometimes added to counter SSRI sexual side effects. Which option fits depends on how well the medication is working overall, so it is a decision to make together.
Medications less likely to cause them
Some antidepressants carry a lower rate of sexual side effects. Bupropion has a notably low rate, and mirtazapine is also low.
These are sometimes chosen for that reason, either at the start of treatment or as a switch. As with any change, the right choice depends on the full picture, including what a medication needs to treat and how a person has responded so far.
A note on effects that persist after stopping
A small number of people report sexual side effects that continue after the antidepressant is stopped. This is sometimes called post-SSRI sexual dysfunction.
It is uncommon and not fully understood. Even so, it is a real phenomenon and worth being aware of. If you notice symptoms that persist after stopping a medication, raise them with a prescriber so they can be looked at properly.
Sources
This guide draws on current prescribing information and public health references. It is reviewed for clinical accuracy and updated as guidance changes.
- National Institute of Mental Health. Mental health medications.
- MedlinePlus, U.S. National Library of Medicine.
- American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder.
Managing a medication needs a prescriber
Any psychiatric medication has to be started and adjusted by a clinician who can follow you over time. If you don't have a prescriber, our guides section explains the options, including in-person care and telepsychiatry, and how to choose between them.
This guide is for general education. It is not medical advice and is not a substitute for evaluation, diagnosis, or treatment by a qualified clinician. Never start, stop, or change a medication without talking to your prescriber. If you are in crisis or thinking about harming yourself, call or text 988 in the U.S. to reach the Suicide and Crisis Lifeline.