Question: How can I increase my sex drive while on an antidepressant?

Answered by Mark E. Thomsen, MD, psychiatrist:

A reduction in libido is often a common side effect of some of the most commonly prescribed antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications increase serotonin, which can inhibit sex drive, arousal, and orgasm. SSRIs and SNRIs are typically the first-line therapy for depression because they help with both depression and anxiety, which often go hand-in-hand. 

However, there are some things you can do to help mitigate low sex drive while taking antidepressants.

Before antidepressants are prescribed, your health care provider should have an open and comprehensive discussion with you about your current libido and sex life to establish a baseline. Depression itself can lower libido, as can other health conditions, such as diabetes and heart disease. Therefore, it’s important to explore whether there may be other existing contributing factors to low sex drive. 

With this information, you and your provider can then develop a more personalized game plan to help manage your depression while minimizing sexual side effects. Potential options include:

• Starting with a lower dose of SSRIs and SNRIs
• Adding a medication that can help counteract sexual side effects
• Considering an alternative antidepressant to SSRIs and SNRIs that have less effect on sex drive. Keep in mind that changing medications can be a challenging and painful process, and the new medication may not be as effective in managing your depression.
• Occasionally withholding a dose of your medication for a day or two, which may improve orgasm, but not necessarily libido 
• Talking to your health care provider about any other prescriptions you are taking to determine whether they may be hindering sex drive and performance
• Giving the antidepressants time to work. This can take six to eight weeks, and sexual side effects may improve as your depression gets better.

Practicing certain lifestyle habits may also improve sex drive:

• Exercise regularly
• Reduce alcohol consumption
• Focus on intimacy and the emotional connection with your partner 

The key is to maintain open communication with your provider to help you better manage both your depression as well as your sex drive. And lastly, be patient. Depression often takes time to improve, with or without medication, and finding the best plan for each person often takes a slow and steady approach.