Andrew John Rynne, MD  
Male, 75
Dublin, Ireland

Specialties: sexual dysfunctions, reverse vasectomy

Interests: sexual medicine, Testosterone Therapy
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The Truth about Antidepressants and Sexual Dysfunctions

May 18, 2014 - 24 comments



SSSRI;s and seuality


sexual dysfunctions


What they Never Tell You about Antidepressants.

Almost every day now, or so it seems to me, I am hearing from young people who are taking antidepressant drugs and who are suffering from a sexual dysfunction as a direct consequence. In men their dysfunction may be erectile dysfunction, loss of libido or sex drive, loss of sensation during ejaculation or loss of ability to climax at all. In women their situation may be similar – loss of interest in matters sexual, an inability to feel orgasm when it eventually arrives, or, worst of all, an inability to reach orgasm at all. These, I think you will have to agree, are pretty devastating side effects for a single drug to have.

When you get your antidepressant dispensed to you by your friendly Community Pharmacist there will be, tucked inside the box, a Patient Information Leaflet. This is an EU or FDA generated document that is supposed to mean something. It is supposed to impart at least some useful information. Let’s look at it for Prozac then, the most popular antidepressant of them all. Under side effects in the category
• Urogenital System and Reproductive Disorders : we have: difficulty in passing urine, passing urine too frequently, poor sexual performance, prolonged erections and the production of breast milk.

Then, under this misinformation there is even more untruths:

              Most of these side-effects are likely to disappear with continued treatment.  

This leaflet was last approved by the FDA and the MHRA (UK) in October 2010. No mention of female inability to orgasm, no mention of male ejaculatory failure, no mention of sexual anhedonia or sexual anesthesia in both men and women and no mention of loss of libido or sex drive in both men and women. All the consumer of modern antidepressants is being told is that there maybe some poor sexual performance. This is meaningless, unfair and disingenuous. But unfortunately, it gets much worse.

Clearly the manufactures of these antidepressants want the consumers to continue consuming in spite of obvious side-effects. To do this they mislead them even further by asserting:

            Most of these side-effects are likely to disappear with continued treatment.  

With respect to the negative sexual effects of the SSRI antidepressants these most certainly do not disappear with continued use. In fact it has been my experience that they get progressively worse with continued use. And not alone that, and this is the really shocking bit, the negative side-effects on human sexuality that modern antidepressants can have, do not disappear even long after the medication has been stopped. Doctors who treat sexual dysfunction on a regular bases as I do, are beginning to now recognise a new post SSRI phenomenon called Persistent Sexual Anesthesia. In my view it is nothing short of criminal that this possibility is not even hinted at on the Patient’s Instruction Leaflet that comes with the drugs.  

If your sex-life has been adversely affected in any way by antidepressants then I would welcome hearing from you. The more people that know about this the better.

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Avatar universal
by MissJayJayJay, May 18, 2014
I'm shocked to read about this. I'm on 20 mg of celexa and have lost my sex drive and ability to climax. I'm also on Klonopin and it helps me to get that back. So it's an up and down battle. -jenny

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by Andrew John Rynne, MDBlank, May 19, 2014
Jenny. You might like to consider phasing yourself off of these medications. Psychotherapy instead may be a better option.

Avatar universal
by Shabisheik, May 19, 2014
Have been on antidepressant/antianxiety meds for 24 years (Zoloft, Effexor; Wellbutrin, Depacote,Topamax, etc.); Cymbalta for 12 of those years.  Cymbalta has been most effective, but side-effects have worsened through the years - inability to achieve orgasm, headaches and ear/eye pressure/pain, water retention, nausea, sleepiness and sleeplessness, nightmares, restless leg syndrome, urinary problems, ringing in the ears and dizziness, kidney pain, etc.  Plus, ongoing bouts of increased anxiety and depression.

Tried SAMe recently, which was awesomely effective in helping me drop Cymbalta and eased withdrawal symptoms, but anxiety ratcheted up within a month and low-level depression continued.  Another benefit of SAMe was wonderful lessening of joint pain!  Then my GI tract could no longer tolerate the 1200-1600 mg dosage (of SAMe) needed to mitigate the side-effects of stopping Cymbalta and to keep depression at  bay.  Now I have developed very painful and  debilitating IBS with extreme abdominal pain and vomiting because of the SAMe.  

I like being free of the side effects of Cymbalta use, but the depression and anxiety have returned, plus I am sick with nausea, diarrhea, and constant bowel pain, I cannot function. Its's true. Doctors just tell you to switch drugs and push through the side-effects of anti-depressants until they disappear or lessen, but my painful experience has proven that that is not true.

I don't know where to go or what to do.  I guess I'll have to try another drug, but I don't have much hope for better long-term results.

Avatar universal
by miam16, May 21, 2014
I have a problem  with my 9 yrs  boy ,who seems to show sin  of touch  his penis ,,and  when  i wake  up at 3  he like moving  in bed and his pens his hard as an adult  is this normal,or must  i take  him  to  the doctor ?

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by Andrew John Rynne, MDBlank, May 22, 2014
In my experience this is normal. There is no need to take him anywhere.What he is doing is not "wrong" so long as he understands that it is private and must not be done in public.

Avatar universal
by maggierae, May 22, 2014
When if ever does this subside?

Avatar universal
by maggierae, May 22, 2014
Stupid question, but if a female does not have a partner what should she do, forget it or use a prop.

Avatar universal
by livingthisnightmare, Jun 22, 2014
This truly is criminal. I took Citalopram for only a week and now have severe sexual dysfunction and I'm basically emotionless now. I don't know how to go on like this.

Avatar universal
by mfoley39, Jul 17, 2014
I took Sertraline (Zoloft) 13 days.  When I realized it had caused frequent urination and a loss of libido, including the inability to achieve a full erection, I stopped taking it.  This was 9 days ago and I still have not gotten my libido or erection back to normal.

How long will it be this way?  Surely 13 days of 50 milligrams per day couldn't have messed me up for life.  I am 55 years old.


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by Andrew John Rynne, MDBlank, Jul 18, 2014
This is going to need medical management. If you wish to visit my website I can help you.

Andrew Rynne

Avatar universal
by Ducati748, Oct 03, 2014
I am very shocked to read your article. I am a 50 year old guy and in 2013 after a sequence of events I was rendered with health anxiety, which I just couldn't bring myself out of. I was prescribed Citalopram 20mg which I have been taking for over a year. Although not immediate I started to notice a loss off libido, difficulty reaching orgasm and sometimes even ejaculating. Reaching orgasm can take well over an hour and the concentration involved is massive and I may not even ejaculate at all, there's a switch which just goes off in my head to stop me reaching orgasm.
3 months ago I decided it was time to come off Citalopram slowly and I reduced my medication from 20 to10 and now 5mg over this period... next month zero! The problem I am left with now is that I don't seem to have a problem getting an erection, although it does take longer than before Citalopram, but maintaining it for any length of time and therefore not reaching orgasm. I am so annoyed, frustrated, upset and scared that I am going to be like this for the rest of my life and I am so worried about the effect it is having on my relationship with my girlfriend.
I have always had a high sex drive and I've never had any problems getting or maintaining an erection or reaching orgasm. Citalopram is criminal, I wish I'd never gone on this drug knowing what I know now, it has ruined my sex life. Is there anyone else out there in the same situation? Is there help out there? Is there a cure? Will I ever return to normal?

Avatar universal
by didi1234, Jan 15, 2015
I had a prostate cancer surgery robotic on May 28th 2013. as of now my incontenece is bad never stopped. it disappeared at night but day time i have to change diapers constant. i was told by my doctor my bladder is small i need to have botox to improve. will that help. i currently take cymbalta 30mg, cialis 5mg and blood pressure pills. i do not have an erction ounce in a while but not enough to have intercourse with my wife. another doctor told me that during the surgery he believes that my spyncter both of them were damaged during the operation. can anyone hlep me please and thanks. my e mail ***@****

Avatar universal
by Macdog54, Mar 12, 2015
I've  been on Zoloft for about 6 weeks. I have no problem maintaining an erection but very hard to reach orgasm. I have experienced many positive from zoloft as it has really helped with my depression. I take 50mg a day. Is there a similar anti-depressant that doesn't cause sexual side effects? Thanks, Paul

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by AndrewRynneMD, Mar 13, 2015
I think if one SSRI gives you delayed ejaculation then any of them will.

Avatar universal
by sport5739, Apr 13, 2015
I started taking Sertraline roughly 5 years ago and have been on and off since, with periods up to 1 year off. Have noticed a dramatic decrease in libido since taking the drug & in the year off there was no increase.

I have had my bloods tested and all seems normal. I can only put it down to taking the drug.

The drug has been a big help in keeping anxiety and depression at bay, but as you say, I was never warned that the sexual side effects would be this bad and certainly not longstanding as they are.

Is there anything that can be done to bring the sex drive back?


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by AndrewRynneMD, Apr 14, 2015
If I knew your age and gender I could help you through my website.

Avatar universal
by bahamamama13165, May 25, 2015
I am a 42 year old female. I took Prozac for 10 years. My sex drive completely disappeared. I just figured it was worth it to get rid of the depression. I always thought when I got off the Prozac my libido would return. Wrong! I have been free of medication for 2 years now and my sex drive never returned. Is there anything I can do to fix it?

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by AndrewRynneMD, May 26, 2015
Your lack of libido may be reversible, at least to some extent. There are a number of things you could try. If you care to avail of Online Consultation with me here www.medicaladviceforyou.com we could see what we could do.

Andrew Rynne

Avatar universal
by stevo88, Jun 06, 2015
Im 27 took anti depressants for many years and add drugs , had problems getting a hard exection my whole life , will these ever go away ? I take xrect secretly I feel if she knew it would ruin our relationship but it's not my fault . I need help .. I don't do much exercising and I don't eat like I should. But I can't really maintain a erection without xrect , I've went to doctor before it didn't help he gave me Cialas , xrect is better and supposedly all natural which i call bs if it works as good as the real stuff.  Any one can get it and it's not expensive .  Anyways I haven't taken adderol in a year and 10 years on anti depressants. Zoloft , lithium, dexadrin the list is like 10 or so I just can't remember them all.

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by AndrewRynneMD, Jun 06, 2015
Sorry, but I can't help you through here. When you say it is not your fault that is correct but there may be better solutions than Xrect.

Avatar universal
by mcvitaller, Mar 11, 2016
Hi Doctor Rynne, I don´t know if you have received a free mail with some questions  through medical advice with a peticion of online appointment. I am Patricia. I am really looking forward to hearing from you.

Thank you

Avatar universal
by mcvitaller, Mar 12, 2016
I have paid 25 euros to talk to the DR: and I havent received any consultation or attention... I havent been able to send him a mail and I had to open a complain through paypal.

Avatar universal
by Worriedwife2, Jun 16, 2016
My husband is 35. We gave been married 16 years. About 12 months ago he started 20 ml then 40 of celexa. Is sex drive went from all the time to hardly nothing with the depression but he could still function. Now he can still get an erevtion but not sustain it for intercourse and sometimes can't get an erection at all. I thought it was me. After reading these posts I'm starting to realize it is most likely his meds but is this reversible? It is causing an issue in our marriage  to say the least. Please help!!

Avatar universal
by eshark, Jan 04, 2017
I'm 33 years old male, I had depression in 2010 and my psychiatrists prescribed me prozac, honestly I didnot take it more than one month and not daily, intermittently, it did nothing for my depression,I had my first sexual experience after 3 years in 2013 and it was as described by PSSD people, no orgasm, ED, no pleasure at all, I've been searching for the reason for last 3 years, I thought first it is Porn induced as I was a porn addict,now I alraedy quit porn but didn't try sexual relation again yet, Iam into another relationship I am afraid that it is PSSD, fornow I can masturbate, I get erection if I saw sexy video or picture, I get morning erection, I don't know what o do, any medications or herbs could help?

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