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In my first post about love, sex, and depression I promised among other things a list of popular antidepressants and their side effects: especially those medications that as a side effect might disrupt your sex life – possibly worsening your depression instead of alleviating it.
So this time, instead of a funny or contemplative post, here is a long list of antidepressants and just about all their known potential side effects. If out of need or curiosity you want to skim through it, then please do read my Introduction first. This is important.
Introduction:
This list is not intended as some kind of medical advice. Medical advice is something you should get from your psychiatrist, in a discussion together with her and your life partner (if you have one). Your psychiatrist ought to know about your specific problems and needs, and what medication might be considered in your case. She knows her trade, and she knows you. I don’t. Right?
So this list here is only meant to help you bringing up possible side effects (and perhaps searching for some medication alternatives) in that discussion you are going to have together with your partner and your doctor or psychiatrist. I hope this is clear.
And this list is certainly not meant to suggest you should just quit using any kind of medication, without first consulting the doctor or psychiatrist who prescribed them. You know as well as I do, that such an impulsive step might be outright dangerous. I’ve always warned here against such irresponsible gambles.
What exactly is meant here with “sexual side effects”? Let’s for once be explicit about that, too. Generally speaking, some often-used antidepressants can cause some of the following sex-related effects:
• decreased or absent libido;
• impotence or vaginal dryness;
• difficulty getting aroused;
• weak or absent orgasm;
• physically complete but not fully felt orgasm;
• premature ejaculation;
• weakened penile, vaginal or clitoral sensitivity;
• decreased or no response to sexual stimuli;
• reduced semen production;
• persistently erected penis or clitoris.
Now don’t panic! First of all, many antidepressants do not have sexual side effects listed at all (see the lower part of my list). Secondly, do not forget we are talking just about potential side effects here: many users of medication with listed side effects will not experience them. “Potential” indicates only that in some cases, for some particular users, some side effects may occur. While you might want to consider that possibility, it would be very wrong to assume beforehand that such effects actually will happen to you if you start using that medication.
A good psychiatrist will try to prescribe that specific medication that she thinks you, in your state and your situation, do need most urgently. She may have very good reasons to prescribe that specific medication for you. If there are side effects listed, then clearly she thinks that your not taking that medication would have much worse overall effects, than your taking the risk of some of its side effects. This is something you can ask her to explain. You can ask her (and your own partner) to help you weighing the pros and cons. Of course you can also ask if there isn’t some alternative medication with the same main result but with different or less potential side effects.
My list has a somewhat wider range of medication than a strict definition of “antidepressants” would allow. I wanted to include most of what often is prescribed in cases of depression, so you will also find things that belong – for example – at the activating or tranquillizing ends of the spectrum. This is not strange because there are many kinds of depression, and sometimes a psychiatrist will advise a combination of different medications to cover your specific condition as a whole.
For most medication categories I give many examples of brand names, but in that respect the list cannot be complete. New names appear all the time (there must be some creative computer somewhere, churning them out on command). Also, identical pills often get different brand names in different parts of the world. Most of the brand name examples here are American, with European ones coming second. If your specific brand of antidepressant is not listed, you will have to find out yourself to what category it belongs.
Finally, we all are unique personalities: your own experiences may be different. I know this from my fifteen-year-stretch of using various antidepressants. My own experience with Nortrilen (a TCA, Tricyclic Antidepressant) does accord with what the list suggests: after I stopped using it, I got the feeling of suddenly getting back a part of my life again – regaining sexual feelings that before had been drowned in a kind of numb indifference. But I have had exactly the same experience after I stopped using Priadel (in the Lithium category). Apparently, Lithium had a similar dulling effect on me too, even though long-term sexual problems are not formally listed as a side effect for the Lithium category. So be not surprised if your individual experiences will not quite fit into the general picture.
Would you rather skip the long and dull list below? Click here to jump right to my Bottom Line.
Antidepressants with potential sexual effects:
UPDATE: The many specific brand names I listed for each of the categories below, caused search engines to wrongly (and stupidly) classify StayOnTop as a dubious commercial pill-pushing site! So regrettably I had to remove all those name lists from this page.
To get the page version that does include all those brand names,
download this PDF file.
Generic category: MAOI, Monoamine Oxidase Inhibitors.
These affect your serotonin/norepinephrine levels.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: bladder problems, diarrhea, dizziness, dry mouth, headache, increased heart rate, insomnia, low blood pressure, muscle aches, nausea, nervousness, sexual problems, sleepiness, vomiting, weight gain.
Generic category: NDRI, Norepinephrine-Dopamine Reuptake Inhibitors.
These affect your dopamine/norepinephrine levels.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: appetite loss, anxiety, constipation, diarrhea, dizziness, drowsiness, dry mouth, headache, insomnia, nausea, palpitations, restlessness, sexual problems, stomach pain, sweating, weight loss.
• Note: Potential side effects may vary here, depending from the active chemical component. For example, the buproprion-based ones are less likely to have sexual side effects than the methylphenidate-based ones.
Generic category: SNRI, Serotonin-Norepinephrine Reuptake Inhibitors.
These affect your serotonin/norepinephrine levels.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: appetite gain or loss, bladder problems, blurred vision, constipation, dilated pupils, dizziness, drowsiness, dry mouth, fatigue, fever/chills, glaucoma, headache, insomnia, lightheadedness, nausea, sexual problems, tremors, vomiting, weight loss.
Generic category: SSRI, Selective Serotonin Reuptake Inhibitors.
These affect your serotonin level.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: dizziness, feeling jittery, headache, insomnia, nausea, sexual problems.
Generic category: TCA, Tricyclic Antidepressants.
These affect your serotonin/norepinephrine levels.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: bladder problems, blurred vision, confusion, constipation, dizziness, drowsiness, dry mouth, fatigue, increased heart rate, sexual problems, tremors, weight gain.
Generic category: TeCA, Tetracyclic Antidepressants.
These affect mainly your norepinephrine level.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: appetite gain, agitation, dizziness, dry mouth, fatigue, headache, increased heart rate, sexual problems, skin problems, sleepiness, sweating, weight gain.
Antidepressants with sexual effects not listed:
Generic category: AAP, Atypical Antipsychotics.
These affect your dopamine level.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: blurred vision, involuntary body movements, muscle spasms, restlessness, weight gain.
Generic category: BZD, Benzodiazepines.
These affect your gamma-aminobutyric acids.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: confusion, dizziness, drowsiness, headache, lack of coordination, lightheadedness, memory problems, unsteadiness.
Generic category: Lithium Ion, Li+ element-based salts.
How exactly these work is as yet still not satisfactorily figured out, but their effectiveness as an antidepressant is undisputed, especially with bipolar depression.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: dehydration, dry mouth, gout, kidney problems, skin problems, thirst, weight gain.
Generic category: NDDI, Norepinephrine-Dopamine Disinhibitors.
These affect your dopamine/norepinephrine levels.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: almost none, as far as I know. Please correct me if necessary.
Generic category: SARI, Serotonin Antagonist and Reuptake Inhibitors.
These affect your serotonin level.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: appetite gain or loss, blurred vision, coordination problems, confusion, constipation, diarrhea, drowsiness, dry mouth, fatigue, headache, increased heart rate, memory problems, muscle pain, nausea, nervousness, skin problems, stomach pain, sweating, swellings, tremor, vomiting, weight gain or loss.
Note: While sexual problems are usually not listed for this category, some of these (such as Trazodone) are said to increase male potency. However, this is sometimes also interpreted as “persistent painful erection”.
Generic category: SSRE, Selective Serotonin Reuptake Enhancers.
These affect your serotonin level.
• Brand names: To get a version of this page that includes all popular brand names here, download this PDF file.
• Potential side effects: constipation, dizziness, drowsiness, dry mouth, headache, insomnia, lightheadedness, sweating.
To make this list more complete, here is also a different and less “formal” category of antidepressants:
Natural Herbs and Vegetal Derivates.
How these work varies, and is generally not very clear, but some of them may affect your serotinin level. Most seem better suited for cases of mild depression than for chronic or serious depression. For a few of them, such as Chocolate, the antidepressant effect is assumed by some people while disputed by others.
Examples: 5-HTP (from Griffonia), Angelica, Camphor, Cannabis (from Marijuana), Cat’s Claw, Chocolate (from Cacao), Clary Sage, Coffee, Damiana, Dwarf Morning-Glory, Geranium, Golden Root (also known as Roseroot or Aaron’s Rod), Gingko Biloba, Ginseng, Jasmine, Kava, Lady’s Slipper, Melissa, Nicotine (from Tobacco), Passion Flower, Saffron, SAM-e (a natural amino acid derivate), Snake Root, St John’s Wort, Turmeric, Valerian, Yellow Gentian (also known as Bitterwort).
Potential physical side effects vary wildly, so it is impossible to list them all here. For the most commonly used antidepressant herb, St John’s Wort, the associated potential side effects are: confusion, dizziness, sedation, skin problems, tiredness.
As for sexual problems, some of these (Damiana, Ginseng) are reputed to have stimulating effects.
Note: A few of these “informal” antidepressants may influence the effects of some “formal” antidepressants. So on your own initiative combining a herbal antidepressant with one prescribed by your psychiatrist, may not always be wise.
Bottom Line:
As already said, if your sexual life matters to you – and it should – then consider having an open and honest talk about this with your psychiatrist, together with your life partner. On the whole I think we can trust psychiatrists to make sensible medication choices, and to explain them to you. But the final decision should of course be your own.
Based on my personal experience, I would like to add that psychiatrists may have two blind spots: (1) sometimes, they tend to prescribe something just out of professional habit or routine, without taking enough time to consider a few alternatives. And (2) sometimes, while concentrating on your most urgent problems, they tend to underestimate the huge importance of a healthy, functional sexual relationship. This can lead them to view something as just “a side effect” while in reality, for you, in a situation where you are already depressed, this sexual “side effect” can amount to a devastating effect.
So my bottom line would be: when your psychiatrist finds it necessary to prescribe an antidepressant, always ask her to present you with two or three different alternatives. Then, carefully – and together with your partner – weigh the pros and cons of each alternative. And of course, if after some weeks or months you get the feeling that your new medication is ruining your sex life, do not just quit taking those pills: instead, go back to your psychiatrist to find a better solution.
For some more information about antidepressants,
go to The Pills page.
• tip: see bottom line above. But maybe I should also repeat an advice I gave here already a few times before: never buy antidepressants from some dubious online store, or without a proper prescription.
May 21, 1949 –
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