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.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Jan. 25, 2020 See more Expert Answers

See also

  1. Addison's disease
  2. Adjustment disorders
  3. Adrenal fatigue: What causes it?
  4. Alzheimer's 101
  5. Alzheimer's disease
  6. alzheimer's genes: are you at risk?
  7. Alzheimer's prevention: Does it exist?
  8. alzheimer's stages: how the disease progresses
  9. alzheimer's: managing sleep problems
  10. Ambien: Is dependence a concern?
  11. Antidepressant withdrawal: Is there such a thing?
  12. Antidepressants and alcohol: What's the concern?
  13. Antidepressants and weight gain: What causes it?
  14. Antidepressants: Can they stop working?
  15. antidepressants: safe during pregnancy?
  16. antidepressants: selecting one that's right for you
  17. Are you at risk of hidradenitis suppurativa?
  18. atypical antidepressants
  19. Binge-eating disorder
  20. Blood Basics
  21. Borderline personality disorder
  22. Can zinc supplements help treat hidradenitis suppurativa?
  23. care tips for hidradenitis suppurativa wounds
  24. Celiac disease
  25. Child abuse
  26. Chronic traumatic encephalopathy
  27. Cigar smoking
  28. CJD - Creutzfeldt-Jakob Disease
  29. Clinical depression: What does that mean?
  30. Clinical trials for hidradenitis suppurativa
  31. Coconut oil: Can it cure hypothyroidism?
  32. Complete blood count (CBC)
  33. Complicated grief
  34. Compulsive sexual behavior
  35. Concussion
  36. Concussion in children
  37. Concussion Recovery
  38. Concussion Telemedicine
  39. coping with the emotional ups and downs of psoriatic arthritis
  40. coping with the stress of hidradenitis suppurativa
  41. Coughing more after quitting smoking: What's the deal?
  42. covid-19 and your mental health
  43. creating a hidradenitis suppurativa care team
  44. Creutzfeldt-Jakob disease
  45. Cushing syndrome
  46. Cyclothymia (cyclothymic disorder)
  47. Delirium
  48. delusional parasitosis
  49. Depression (major depressive disorder)
  50. Depression and anxiety: Can I have both?
  51. depression and anxiety: exercise eases symptoms
  52. depression during pregnancy: you're not alone
  53. depression in women: understanding the gender gap
  54. Diabetes and depression: Coping with the two conditions
  55. diagnosing alzheimer's: how alzheimer's is diagnosed
  56. Did the definition of Alzheimer's disease change?
  57. Dissociative disorders
  58. Dr. Mark Truty (surgery, MN) better outcomes with chemo
  59. Dr. Wallace Video
  60. Drug addiction (substance use disorder)
  61. Electroconvulsive therapy (ECT)
  62. Fibromyalgia
  63. HABIT program orientation
  64. Hangovers
  65. Hashimoto's disease
  66. Hidradenitis suppurativa
  67. Hidradenitis suppurativa and diet: What's recommended?
  68. hidradenitis suppurativa and sleep: how to get more zzz's
  69. hidradenitis suppurativa: tips for weight-loss success
  70. Hidradenitis suppurativa: What is it?
  71. hidradenitis suppurativa: when does it appear?
  72. Hidradenitis suppurativa: Where can I find support?
  73. HIL Article English
  74. HIL Article English
  75. HIL Article English
  76. HIL Article English
  77. HIL Article English
  78. HIL Article English
  79. HIL Article English
  80. Hookah smoking
  81. how opioid use disorder occurs
  82. Hyperparathyroidism
  83. Hypoparathyroidism
  84. Hypothyroidism (underactive thyroid)
  85. Hypothyroidism and joint pain?
  86. Hypothyroidism diet
  87. Hypothyroidism symptoms: Can hypothyroidism cause eye problems?
  88. Hypothyroidism: Can calcium supplements interfere with treatment?
  89. Hypothyroidism: Should I take iodine supplements?
  90. Infographic: Pancreatic Cancer: Minimally Invasive Surgery
  91. Infographic: Pancreatic Cancers-Whipple
  92. Insomnia
  93. insomnia treatment: cognitive behavioral therapy instead of sleeping pills
  94. Insomnia: How do I stay asleep?
  95. intervention: help a loved one overcome addiction
  96. Is depression a factor in rheumatoid arthritis?
  97. kratom for opioid withdrawal: does it work?
  98. Lack of sleep: Can it make you sick?
  99. lecanemab for alzheimer's disease: an option for you?
  100. Low blood pressure (hypotension)
  101. male depression: understanding the issues
  102. Managing Headaches
  103. managing hidradenitis suppurativa: early treatment is crucial
  104. managing other health risks when you have hidradenitis suppurativa
  105. MAOIs and diet: Is it necessary to restrict tyramine?
  106. Marijuana and depression
  107. Mayo Clinic Minute: 3 tips to reduce your risk of Alzheimer's disease
  108. Mayo Clinic Minute: Alzheimer's disease risk and lifestyle
  109. Mayo Clinic Minute: Avoid opioids for chronic pain
  110. Mayo Clinic Minute: Be careful not to pop pain pills
  111. Mayo Clinic Minute: Do not share pain medication
  112. Mayo Clinic Minute: New definition of Alzheimer's changes
  113. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  114. Mayo Clinic Minute: Restless legs syndrome in kids
  115. Mayo Clinic Minute: Weathering migraines
  116. Mayo Clinic Minute: Women and Alzheimer's Disease
  117. Medication overuse headaches
  118. meditation: a simple fast way to reduce stress
  119. memory loss: when to seek help
  120. mental health providers: tips on finding one
  121. mental health: overcoming the stigma of mental illness
  122. mental health: what's normal what's not
  123. Mental illness
  124. Migraine
  125. Migraine FAQs
  126. Migraine medicines and antidepressants
  127. Migraine treatment: Can antidepressants help?
  128. Migraines and gastrointestinal problems: Is there a link?
  129. Migraines and Vertigo
  130. Migraines: Are they triggered by weather changes?
  131. migraines: simple steps to head off the pain
  132. Mild cognitive impairment (MCI)
  133. Natural remedies for depression: Are they effective?
  134. Nervous breakdown: What does it mean?
  135. New Alzheimers Research
  136. Nicotine addiction
  137. Nicotine dependence
  138. Occipital nerve stimulation: Effective migraine treatment?
  139. Ocular migraine: When to seek help
  140. Opioid stewardship: What is it?
  141. Oppositional defiant disorder (ODD)
  142. Pain and depression: Is there a link?
  143. Pancreatic cancer
  144. Pancreatic Cancer Survivor
  145. Perimenopause
  146. Pituitary tumors
  147. Polymyalgia rheumatica
  148. Poppy seed tea: Beneficial or dangerous?
  149. Premenstrual dysphoric disorder
  150. Premenstrual syndrome (PMS)
  151. Prescription drug abuse
  152. prescription sleeping pills: what's right for you?
  153. Progressive supranuclear palsy
  154. Psychotherapy
  155. quit-smoking products: boost your chance of success
  156. quitting smoking: 10 ways to resist tobacco cravings
  157. reducing the discomfort of hidradenitis suppurativa: self-care tips
  158. Restless legs syndrome
  159. Salt craving: A symptom of Addison's disease?
  160. Schizoaffective disorder
  161. Seasonal affective disorder (SAD)
  162. seasonal affective disorder treatment: choosing a light box
  163. selective serotonin reuptake inhibitors (ssris)
  164. serotonin and norepinephrine reuptake inhibitors (snris)
  165. sleep tips: 6 steps to better sleep
  166. smokeless tobacco products
  167. Soy: Does it worsen hypothyroidism?
  168. staying active with hidradenitis suppurativa
  169. stress symptoms: effects on your body and behavior
  170. suicide grief
  171. Sundowning: Late-day confusion
  172. support groups: make connections get help
  173. surgery for hidradenitis suppurativa
  174. Symptom Checker
  175. test-page
  176. Thyroid peroxidase antibody test: What is it?
  177. tianeptine: is safe use possible?
  178. Tinnitus and antidepressants
  179. Transcranial magnetic stimulation
  180. Traumatic brain injury
  181. treating hidradenitis suppurativa: explore your options
  182. Treatment of parathyroid disease at Mayo Clinic
  183. treatment-resistant depression
  184. tricyclic antidepressants and tetracyclic antidepressants
  185. Understanding the difference between dementia types
  186. Vagus nerve stimulation
  187. Valerian: A safe and effective herbal sleep aid?
  188. Vascular dementia
  189. Video: Alzheimer's drug shows early promise
  190. Video: Vagus nerve stimulation
  191. Vitamin B-12 and depression
  192. Vitamin C and mood
  193. What are opioids and why are they dangerous?
  194. What are the signs and symptoms of hidradenitis suppurativa?
  195. What is a migraine? A Mayo Clinic expert explains
  196. What is depression? A Mayo Clinic expert explains.
  197. What is pancreatic cancer? A Mayo Clinic expert explains
  198. What is thirdhand smoke, and why is it a concern?
  199. Wilson's disease
  200. young-onset alzheimer's: when symptoms begin before age 65