In our guide to the biggest risk factors for erectile dysfunction, we listed a variety of widely used medications. This list included antidepressants, which are used by almost 13% of adult men and women in the United States. As it happens, antidepressants and erectile dysfunction have a very close link that most men may not consider prior to or during treatment.
In fact, antidepressants are one of the classes of medication most closely linked to sexual dysfunction in men. Some antidepressants, such as SSRIs, have been recorded as causing sexual issues for as much as 60% of patients that take them on a regular basis.
In this guide, we’ll explain how SSRIs and other antidepressants can cause sexual dysfunction such as ED, as well as the treatment options that are available if you have sexual side effects from prescription antidepressant use.
Not-So-Fun-Fact: Almost all antidepressants have sexual dysfunction listed as a side effect. In men, this is most commonly manifested as a reduction in sex drive (decreased libido) and difficulties developing and maintaining an erection.
Some antidepressants can also make it difficult to orgasm, while others, including citalopram, are linked to significant hormonal disruptions and a large reduction in sperm count.
Sexual side effects such as ED are a side effect of almost all antidepressants, including all of the drugs listed below:
So, in short: Yes. Antidepressants and erectile dysfunction pair well together, unfortunately. If you’re prescribed one of these medications and have noticeable sexual side effects such as erectile dysfunction, it could potentially be a side effect of the antidepressant.
Most antidepressants are selective serotonin reuptake inhibitors (SSRIs), a class of drugs that treat depression and anxiety disorders by increasing the amount of serotonin in the body.
Serotonin is a neurotransmitter that contributes to feelings of happiness and wellbeing, making it important in the treatment of depression, anxiety, panic disorders, eating disorders and a variety of other conditions.
In addition to producing feelings of calmness and relaxation, serotonin and erectile dysfunction are linked because it can also result in lower levels of sexual interest. One recent study even states that SSRI users notice an impact on the feelings of love and attachment they experience towards their romantic partner.
SSRIs also have a direct effect on many of the hormones that regulate sexual behavior in both men and women.
For example, many SSRIs cause an increase in prolactin—a hormone that can make it more difficult for men to orgasm and is linked to post-coital sleepiness. Animal studies also suggest that SSRIs can reduce testosterone levels, resulting in a weaker libido.
In short, there are numerous ways in which SSRIs and other antidepressants can affect your sex life. From reduced libido to difficulty orgasming, this class of drug is linked to a range of sexual side effects that can differ from person to person.
Erectile dysfunction medications such as sildenafil have proven useful in treating many of the sexual side effects caused by SSRIs.
One study from 1999 involved 14 male patients, all of whom experienced sexual dysfunction from SSRI use. The patients were given 25-100 mg tablets of sildenafil, which they took just before sexual activity.
Thirteen out of the 14 patients, all of whom previously reported sexual dysfunction, experienced an improvement after using sildenafil. Most saw a noticeable improvement at the smallest 25 mg dose, while others required a 75 mg or 100 mg dosage for noticeable results.
In short, drugs like sildenafil appear to work very well in treating erectile dysfunction caused by antidepressants.
The link between antidepressants and erectile dysfunction are clear. If you take antidepressants and have erectile dysfunction, it’s important to talk to your doctor before you consider using medication to treat your ED.
Not all antidepressants have the same side effect profile, meaning your doctor may be able to recommend an alternative medication that treats your depression or anxiety symptoms without the same impact on your sexual desire and performance.
Alternatively, your doctor might recommend adjusting your antidepressant dosage, which can—in some cases—reduce or eliminate the sexual side effects caused by the medication.
Finally, there’s the option of using ED drugs like sildenafil, tadalafil or vardenafil. As always, it’s best to discuss this with your doctor to learn more about how these drugs can be used safely in conjunction with your depression or anxiety medication. You may find it's not as simple as asking, "Can you take Viagra with antidepressants?"