From the Research
Hydroxyzine can cause sexual side effects in some individuals, though these are not among its most common adverse effects. Sexual side effects may include decreased libido, difficulty achieving orgasm, and erectile dysfunction in men. These effects occur because hydroxyzine is an antihistamine that blocks histamine H1 receptors and has anticholinergic properties, which can affect sexual function. The likelihood of experiencing sexual side effects appears to be dose-dependent, with higher doses increasing the risk. If you experience sexual side effects while taking hydroxyzine, discuss them with your healthcare provider, as dosage adjustments or alternative medications may be considered. These side effects are typically reversible upon discontinuation of the medication. Compared to some other psychiatric medications like SSRIs or antipsychotics, hydroxyzine generally has a lower incidence of sexual dysfunction, which may make it a preferable option for patients concerned about these particular side effects.
Key Points to Consider
- The most recent and highest quality study on the topic of sexual side effects and psychotropic drugs, including hydroxyzine, is from 2021 1, which highlights the association between sexual dysfunction and antidepressant drug therapy.
- Another study from 2021 2 reports a case of hydroxyzine-induced priapism, indicating that hydroxyzine can cause severe sexual side effects, although this is rare.
- A study from 2024 3 compared the incidence of ejaculation dysfunction among various antidepressants and found that some antidepressants have a significant risk of ejaculation dysfunction, but hydroxyzine was not specifically mentioned in this study.
- The mechanism of action of hydroxyzine and its metabolite, norchlorcyclizine, may contribute to its potential to induce erections, as suggested by a study from 1994 4.
Recommendations
- If you experience sexual side effects while taking hydroxyzine, discuss them with your healthcare provider, as dosage adjustments or alternative medications may be considered.
- Consider the potential benefits and risks of hydroxyzine compared to other psychiatric medications, taking into account the individual patient's concerns and medical history.
- Be aware of the rare but potential risk of severe sexual side effects, such as priapism, when prescribing or taking hydroxyzine.