SSRIs' Effect on Your Sex Drive

If you’ve searched the internet for information about SSRIs and sexual side effects, the results can feel surprising, or even scary. While it’s true that sexual side effects are some of the most widely reported, going on an antidepressant doesn’t mean choosing between your mental health and your sexual health. Severity and duration of side effects can vary, and if you do experience side effects, you and your clinician can change or adjust your treatment plan. The most important thing is to find the right balance, have honest conversations about your goals and experiences, and to collaborate with your clinician on the best next steps for you.

Talkiatry psychiatrists who specialize in medication management regularly work with patients on SSRI sexual side effects, and there are real, evidence-based options. This article covers what's happening, why, and what you can do about it.

Why does this happen?

SSRIs work by increasing serotonin activity in the brain. That helps with depression and anxiety, but it also influences pathways involved in desire, arousal, and orgasm.¹ When serotonin goes up, some of those sexual response systems go down. How much varies from person to person, and not everyone on an SSRI will experience sexual side effects. For those who do, the effects can range from barely noticeable to seriously disruptive.

Is it the SSRI or the depression?

Both depression and SSRIs can affect sexual function, but they tend to show up differently. Depression more often reduces desire and interest. SSRIs typically interfere with orgasm and physical sensation.^2,3

If you had low desire before starting your medication, the SSRI may not be the only factor at play. A psychiatrist can help sort out what's causing what. If your symptoms stem from depression, improving your mood may restore sexual function on its own. If they're medication-driven, there are other strategies that can help.

What can you do about it?

There are several proven ways to manage these side effects, including: adjusting the dose of your SSRI, switching to a lower-risk medication (like bupropion or mirtazapine),^1,4 or just supplementing your current medication with bupropion.^4,5 For some people, changing the time when they take their dose can even make a difference.

What matters most: don't stop your SSRI on your own. Abrupt discontinuation can cause withdrawal symptoms and increase the risk of depressive relapse.⁶ This is a problem with solutions, but they work best with a psychiatrist guiding the process.  

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The bottom line

Sexual side effects from SSRIs are common and manageable. You don't have to choose between your mental and sexual health. If you're experiencing any of these side effects, bring it up with your psychiatrist; it's a clinical conversation they've had many times before.

Getting started with Talkiatry

Talkiatry is a national psychiatry practice that makes it easier to get care from doctors who listen. Start by answering a few questions online, then get matched with a psychiatrist based on your needs. From there, you can schedule a visit, often within days, and meet with your provider from home. First visits are 60 minutes, so there's time to talk through what's going on and build a treatment plan together. Talkiatry is in-network with most major insurers, and you can check your coverage during the free online assessment.

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Medical disclaimer and sources

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

1. Montejo AL, et al. “Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1,022 outpatients.” The Journal of Clinical Psychiatry. 62(Suppl 3):10-21. February 2001. https://pubmed.ncbi.nlm.nih.gov/11229449/
2. Kennedy SH, et al. “Sexual dysfunction before antidepressant therapy in major depression.” The Journal of Affective Disorders. 56(2-3):201-208. December 1999. https://pubmed.ncbi.nlm.nih.gov/10701478/
3. Lorenz T, et al. “Antidepressant-induced female sexual dysfunction.” Mayo Clinic Proceedings. 91(9):1280-1286. August 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6711470/
4. Clayton AH, et al. “A placebo-controlled trial of bupropion SR as an antidote for SSRI-induced sexual dysfunction.” The Journal of Clinical Psychiatry. 65(1):62-67. January 2004. https://pubmed.ncbi.nlm.nih.gov/14744170/
5. Safarinejad MR. “Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in a randomized, double-blind, placebo-controlled study.” The Journal of Psychopharmacology. 25(3):370-378. March 2011. https://pubmed.ncbi.nlm.nih.gov/20080928/
6. Higgins A, et al. “Antidepressant-associated sexual dysfunction: impact, effects, and treatment.” Drug, Healthcare and Patient Safety. 2:141-150. September 2010. https://pmc.ncbi.nlm.nih.gov/articles/PMC3108697/

Frequently asked questions

Do SSRI sexual side effects go away on their own?

Sometimes. Some people notice improvement after the first few months, but these side effects probably won’t go away completely on the same dose.¹ They typically improve after adjusting your dose or switching or adding medications. In rare cases, symptoms can persist even after you’ve stopped taking medication altogether; this is a condition called post-SSRI sexual dysfunction (PSSD). If you've stopped your SSRI and are still noticing sexual side effects weeks or months later, talk to your psychiatrist.

Should I stop taking my SSRI if it affects my sex drive?

No. Do not stop your SSRI without talking to your prescriber. Abrupt discontinuation can cause withdrawal symptoms and increase the risk of depressive relapse. Your psychiatrist can help you find a solution that works for both your mental and sexual health.

Can adding bupropion help with SSRI sexual side effects?

Evidence supports it, particularly for women.^4,5 Bupropion increases dopamine activity, which can counteract some of the sexual side effects that SSRIs cause by suppressing it.⁴ This is a common strategy psychiatrists use when the SSRI is otherwise working well.