Antidepressants are among the most commonly prescribed medications in the United States, and decreased libido is a common side effect. According to a survey conducted by the Centers for Disease Control and Prevention, about 13% of U.D. adults used antidepressants within 30 days of the survey. Approximately 17.7% of women and 8.4% of men use antidepressants. This is an average of 17.5 million adults each year.¹ Antidepressant use increases with age and education.

Based on these statistics, it is clear that social acceptance and use of antidepressants has increased. This parallels an increase in interest in age management and cognitive health. Living a physically and cognitively healthy life is a high priority, and for some people, antidepressants can improve mental quality of health. However, it is important to evaluate their risks and benefits. Like all medications, antidepressants have side effects, including decreased libido and other sexual side effects.

Why Do Certain Antidepressants Lower Libido? 

Sexual side effects from antidepressants vary by person, but common problems reported include the following:²

• Decreased sex drive
• Decreased sexual excitement
• Diminished or delayed orgasm
• Erectile dysfunction
• Delayed ejaculation
• Priapism
• Painful ejaculation
• Loss of sensation

Loss of libido is one of the more common sexual side effects, especially when taking selective serotonin reuptake inhibitors. These medications are intended to increase serotonin in the brain, which can improve mood and reduce anxiety. Unfortunately, it can also decrease libido.

Types Of Antidepressants 

Several classes of antidepressants are available. Sometimes switching from one class to another can help reduce side effects. Here are some commonly prescribed antidepressants and their most common side effects.²

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are a first-line treatment option for depression. They inhibit serotonin uptake. Approximately 25% to 75% of patients have sexual dysfunction as a side effect. Common concerns include decreased libido, delayed or inability to reach an orgasm, delayed ejaculation, and erectile dysfunction.²

Other common side effects include:

• Gastrointestinal symptoms
• Headache
• Drowsiness
• Insomnia
• Dry mouth
• Nervousness
• Decreased appetite

SSRIs are commonly prescribed. Many of these common side effects improve after taking the medication for a while.

Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs)

SNRIs inhibit serotonin and norepinephrine uptake. Approximately 50% to 70% of people taking SNRIs experience sexual side effects. Common sexual side effects include erectile dysfunction, delayed ejaculation, and delayed or absent orgasm.²

Other common side effects include:

• Excessive sweating
• Headache
• Dry mouth
• Nausea

Noradrenaline And Specific Serotonergic Antidepressants (NASSAs)

NaSSA is a newer class of medications. They are intended for people who cannot take SSRIs. The side effects are similar to SSRIs, but they tend to cause fewer sexual side effects but can cause more drowsiness when you first start taking them.

Common side effects include:

• Weight gain
• Dry mouth
• Drowsiness
• Constipation
• Dizziness

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants are used to treat depression and obsessive-compulsive disorder. They inhibit serotonin and norepinephrine uptake. They are an older class of antidepressants. Approximately 30% of people who take tricyclic antidepressants experience sexual side effects.²

Other common side effects include:

• Dry mouth
• Blurred vision
• Sweating
• Dizziness or lightheadedness
• Drowsiness
• Urinary retention and constipation
• Weight gain
• Erectile dysfunction
• Low libido

Because of their high rate of side effects, they are no longer used as first-line medications for depression.

Serotonin Antagonists And Reuptake Inhibitors (SARIs)

SARIs increase serotonin levels and block their uptake.

Common side effects include:

• Vomiting, diarrhea, nausea
• Fatigue
• Dizziness
• Blurred vision
• Headaches
• Muscle pain

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs block the enzyme monoamine oxidase. This enzyme blocks enzymes that break down serotonin, dopamine, and norepinephrine. Approximately 40% of people taking MAOIs have sexual side effects, including decreased libido and delayed orgasm.

MAOIs are rarely prescribed because their side effects include:

• Dizziness and lightheadedness
• Drowsiness
• Headache
• Weakness
• Fatigue
• Tremors
• Dry mouth
• Constipation
• Weight gain

MAOIs also have the potential to cause severe side effects, including severe headaches, heart-related symptoms, and chest pain.

Besides these common side effects, the FDA requires that all antidepressants carry a black box for suicide risk. Suicide risks are highest in children, adolescents, and adults under the age of 25, especially when starting a new medication or changing the dose. In the long run, antidepressants reduce depression and improve mood and reduce the overall suicide risk.

Hair loss is a rare side effect when taking any of the antidepressants. In one study, bupropion was the most likely to cause hair loss, and paroxetine was the least.⁴

Increasing Libido While Taking Antidepressants 

In addition to continuing your medication, supplements, and lifestyle changes can help improve your libido. Before taking supplements, check with your doctor or pharmacist to see if there are any adverse interactions.

Stimulating Supplements

Supplements can increase libido. Some to consider include the following:

• Zinc
• Magnesium
• Oxytocin
• PT-141
• DHEA
• Estrogen therapies
• Testosterone treatments

Lifestyle Changes 

Low libido and erectile dysfunction are common side effects men experience when taking antidepressants. Here are seven things for men to consider to treat low libido:

• Have your testosterone levels checked
• Check medication side effects
• Manage your stress
• Stop smoking
• Reduce or moderate alcohol consumption
• Manage your weight
• Prioritize exercise

Women also experience low libido when taking antidepressants. Here are some common lifestyle treatment options (many of these work for anyone!) to add to your list:

• Get 7 to 9 hours of restful sleep each night
• Consume a well-balanced diet
• Prioritize exercise
• Reduce or moderate alcohol consumption
• Spend time with your partner

Talking To Your Doctor About Changing Your Antidepressant

If you are taking a prescribed antidepressant, it is important to talk with your doctor about any and all adverse reactions you are experiencing, including decreased libido when taking antidepressants. It can be dangerous to change your medication dose or stop taking it. Antidepressants can cause withdrawal symptoms, especially if you have been taking them for more than six weeks.

See if you can switch antidepressants, decrease the dose, or change the medication timing. These changes may reduce your side effects and allow you to continue on a medication that improves your quality of life.

DISCLAIMER

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References:

1. Almohammed OA, Alsalem AA, Almangour AA, Alotaibi LH, Al Yami MS, et al. (2022) Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States. PLOS ONE 17(4): e0265928. https://doi.org/10.1371/journal.pone.026592
2. Higgins A, Nash M, Lynch AM. Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug Healthc Patient Saf. 2010;2:141-50. doi: 10.2147/DHPS.S7634. Epub 2010 Sep 9. PMID: 21701626; PMCID: PMC3108697.
3. Kent JM. SNaRIs, NaSSAs, and NaRIs: new agents for the treatment of depression. Lancet. 2000 Mar 11;355(9207):911-8. doi: 10.1016/S0140-6736(99)11381-3. Erratum in: Lancet 2000 Jun 3;355(9219):2000. PMID: 10752718.
4. Etminan, Mahyara; Sodhi, Mohitb; Procyshyn, Ric M.c; Guo, Michaela; Carleton, Bruce C.d,e,f. Risk of hair loss with different antidepressants: a comparative retrospective cohort study. International Clinical Psychopharmacology 33(1):p 44-48, January 2018. | DOI: 10.1097/YIC.0000000000000191

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