Antidepressant Sexual Side Effects: What You Need to Know

When you start taking an antidepressant, a medication used to treat depression and some anxiety disorders. Also known as antidepressant drugs, it can help lift your mood—but for many, it comes with an unexpected cost: sexual side effects. These aren’t rare or minor. Up to 70% of people on SSRIs like sertraline or escitalopram report reduced libido, trouble getting or keeping an erection, or delayed or absent orgasm. It’s not weakness. It’s biology.

These side effects happen because antidepressants change brain chemicals like serotonin, which helps regulate mood—but also plays a key role in sexual response. SSRIs, a common class of antidepressants that increase serotonin levels. Also known as selective serotonin reuptake inhibitors, they’re often the first choice for depression because they’re generally safe. But their effect on sexual function is well-documented and often underdiscussed. Not all antidepressants act the same. Bupropion, for example, is less likely to cause sexual problems and is sometimes chosen specifically because of this. Mirtazapine and vortioxetine also tend to have lower rates of sexual side effects. If you’re struggling, it’s not about finding the "right" person—it’s about finding the right drug for your body.

And it’s not just about sex. These side effects can damage relationships, lower self-esteem, and make people quit their medication—even when it’s working for their depression. That’s why talking to your doctor isn’t a sign of failure. It’s the next step in treatment. Options include lowering the dose, switching meds, adding a drug like bupropion to counteract the side effects, or timing sex around your pill schedule. Some people even use short-term treatments like sildenafil (Viagra) under medical guidance.

You’re not alone. Millions face this. And while it’s uncomfortable to bring up, it’s one of the most common reasons people stop taking antidepressants. The good news? There are real, practical solutions. Below, you’ll find posts that break down which antidepressants are most likely to cause these issues, how to spot them early, what alternatives exist, and how to talk to your doctor without feeling embarrassed. This isn’t theoretical. These are real strategies used by people who got their sex life back—without giving up their mental health progress.