Should I start a selective serotonin reuptake inhibitor (SSRI) to increase my libido?

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No, Do Not Take an SSRI to Increase Your Sex Drive

SSRIs consistently cause sexual dysfunction—including decreased libido—in 40-90% of patients and should never be used to enhance sex drive. 1, 2

Why SSRIs Are Contraindicated for Libido Enhancement

SSRIs work by increasing serotonin, which directly suppresses sexual function through multiple mechanisms including delayed orgasm, decreased genital sensation, and reduced sexual desire. 3 This is the opposite of what you're seeking.

Sexual Dysfunction Rates by SSRI

The evidence shows all SSRIs cause significant sexual problems, though rates vary:

  • Paroxetine: 70.7% - highest sexual dysfunction rate among all SSRIs 1, 2
  • Escitalopram: 40-90% - depending on assessment method 1
  • Sertraline: 14% ejaculatory failure, 6% decreased libido (likely underreported) 2
  • Fluoxetine: moderate-high rates 2

These rates are vastly underreported in clinical trials, with actual real-world rates likely much higher. 2

Specific Sexual Side Effects You Would Experience

If you took an SSRI, you would likely develop:

  • Decreased libido (reduced sexual desire) 3, 4
  • Delayed or absent orgasm - the most common effect 1, 4
  • Erectile dysfunction (in men) 1, 3
  • Decreased genital sensation 5
  • Reduced arousal and lubrication (in women) 3, 4

These effects are strongly dose-related and typically emerge within the first week of treatment. 1, 2

The Paradoxical Medical Use

SSRIs are actually prescribed to delay ejaculation in men with premature ejaculation precisely because they suppress sexual function. 1 This therapeutic use confirms that SSRIs have the exact opposite effect of what you want.

Risk of Persistent Sexual Dysfunction

A critical warning: Sexual dysfunction from SSRIs can persist indefinitely even after stopping the medication in a condition called Post-SSRI Sexual Dysfunction (PSSD). 5, 6 This means you could permanently damage your sexual function by taking an SSRI, with decreased capacity to experience sexual pleasure being the most frequent long-term complaint. 6

What You Should Consider Instead

If you're experiencing low libido, the appropriate evaluation includes:

  • Check testosterone levels (total morning testosterone >300 ng/dL in men) - low testosterone independently causes decreased libido 2
  • Evaluate for underlying depression - untreated depression itself causes low libido 7
  • Consider psychosocial factors - relationship issues, stress, and interpersonal functioning affect sexual desire 3
  • Referral to sexual health specialist for persistent symptoms 2

If Depression Is Present and Requires Treatment

If you have depression requiring medication and want to preserve sexual function, bupropion is the only antidepressant recommended as first-line therapy, with sexual dysfunction rates of only 8-10% compared to 40-90% with SSRIs. 2 Bupropion may actually increase libido in some patients. 2

Contraindications to bupropion: Do not use if you have seizure disorders or are highly agitated. 2

Critical Safety Warning

Never combine SSRIs with MAOIs due to risk of potentially fatal serotonin syndrome (symptoms: tremor, agitation, fever, seizures). 1 If you're already on any psychiatric medications, consult your physician before making changes.

References

Guideline

Management of SSRI-Induced Sexual Dysfunction in Men

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

SSRI-Associated Sexual Dysfunction

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Effects of SSRIs on sexual function: a critical review.

Journal of clinical psychopharmacology, 1999

Research

Sexual dysfunction induced by serotonin reuptake antidepressants.

Journal of sex & marital therapy, 1998

Guideline

Management of Post-SSRI Sexual Dysfunction (PSSD) After SSRI Overdose

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Sexual Consequences of Post-SSRI Syndrome.

Sexual medicine reviews, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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