The Most Common Prozac Sexual Side Effects

Prozac^® has done wonders for many people with mood disorders over the last few decades, and it’s changed enough lives to enter the cultural zeitgeist. We know characters in TV and film who take Prozac, whose lives and relations change because of Prozac, and even a few who experience Prozac sexual side effects.

While TV and film may be fictional entertainment, the risk of sexual side effects from antidepressants is fairly well-established. They don’t affect everyone, but plenty of people have experienced issues around Prozac libido and sex drive changes.

Whether you’re about to take your first dose of Prozac, have been taking it for a few weeks, or are a veteran of antidepressant medications, you may have seen changes yourself or worry about what may happen if you do see them.

Sexual side effects can happen — let’s unpack how Prozac can cause them and how to cope.

Prozac is the brand name version of a generic drug called fluoxetine, which belongs to the antidepressant class called selective serotonin reuptake inhibitors. 

It’s FDA-approved for the treatment of:

• Major depression and depressive disorder

• Obsessive-compulsive disorder

• Bipolar disorder (when in combination with olanzapine) 

• Panic disorder

• Bulimia

It is used off-label in the treatment of post-traumatic stress disorder (PTSD) and social anxiety disorder, among other things.

Selective serotonin reuptake inhibitors like fluoxetine work by balancing the serotonin activity in your brain. And while Prozac is an effective medication for people with a variety of mental health conditions, it comes with some risks of side effects. These can include:

• Diarrhea

• Nausea 

• Headache

• Dry mouth

• Irritability

• Insomnia

• Weight gain or loss

Not everyone gets these side effects, and most of them usually go away after a week or so, but fluoxetine can also cause adverse effects when it comes to your bedroom activities — i.e., sexual function.

According to a review of studies, it’s a pretty common issue, with 28 percent to 75 percent of men and women on SSRIs experiencing some side effects related to sexual desire and performance.

Experts aren’t yet aware of precisely why Prozac and other antidepressants cause sexual side effects. However, research suggests that it’s likely related to their effects on serotonin, which is involved in the human sexual response.

Several fluoxetine sexual side effects can occur in both men and women and understanding both can help paint the bigger picture of what’s going on. For men, SSRI-induced sexual dysfunction may look like:

• Decreased interest and arousal

• Sexual performance issues like erectile dysfunction

• Difficulty with orgasm and ejaculation

Sexual Side Effects of Prozac in Women

For women, the sexual effects of Prozac might include:

• Decreased orgasm (anorgasmia) 

• Decreased libido or sexual desire

• Decreased lubrication

As an SSRI, Prozac is less likely to cause side effects and drug interactions than older classes of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

Still, these side effects can interfere with your sex life, which could decrease your self-confidence and lead to intimacy issues, and if not dealt with in a healthy manner, they could cause relationship problems as well.

So, can you make this go away? Possibly! This is partly because it depends on what sexual problems you personally experience.

For example, decreased lubrication is an issue for many women both on and not on antidepressants. Luckily, there are a variety of healthy, safe lubricants designed to increase your enjoyment with a partner, toy, or whatever else your imagination may come up with. 

That said, we’re still quite short of clinical trials showing that other side effects of Prozac can be mitigated, but a few anecdotal sources of hope exist. 

For example, a case study from 1992 suggests that the antihistamine cyproheptadine could reduce the symptoms of anorgasmia, and a similar case study looked at sexual dysfunction side effects from Prozac in men a year earlier.

But to our knowledge, this hasn’t been replicated since the ‘90s, and it doesn’t appear that prescribing cyproheptadine has become anything like a standard.

Your healthcare provider may also suggest other options for your sexual side effects, including:

• Changing your dosage or adjusting your dosage schedule. If you use a high dose of Prozac and have sexual health issues, your provider may lower your daily dose to see if sexual arousal returns. Or, if you notice that your sex drive seems to decrease shortly after you take your medication, you may want to try changing the time of day that you take it.

• Waiting for side effects to improve. Some people only experience side effects in the first few months of treatment, and then they disipate over time. If you’ve recently started taking Prozac and feel like your sex drive is weaker or it takes longer for you to climax, your healthcare provider might recommend waiting to see if your side effects get better on their own. It usually takes two to four weeks for many antidepressants to start working effectively.

• Switching antidepressants. Many people try a few antidepressants before finding the right combination of improved symptoms and tolerable side effects. In fact, lots of people switch medications more than once before finding an antidepressant that feels right for them. More on this ahead!

These solutions may feel frustrating to hear and might lead you back to that simple question: Should you stop taking Prozac to prevent the sexual side effects?

We’ll dig into this ahead and also outline specific alternatives to Prozac.

There are two situations in which you might be asking this question: Either you’re already on this antidepressant treatment, or you’re considering starting an antidepressant and are worried about the potential impact on your quality of life. 

If you’re in the latter group, it’s important to remember first that not all side effects are permanent. While some may stay indefinitely, most side effects are considered temporary and will dissipate as your brain adjusts to the medication.

If you’re already on Prozac, the short answer here is no — you shouldn’t simply stop taking an antidepressant medication because of side effects, at least not without talking to a healthcare professional first.

Going off antidepressants can lead to some potential side effects, like withdrawal. The other important important thing to remember is that your treatment for depression will, you know, stop It’s not to say you can’t stop this medication — just that you’ll want to have a healthcare professional in the driver’s seat for help. 

In the event that you do go off of Prozac, you may be directed to another medication to treat depression. Your healthcare provider may suggest trying a different SSRI, like:

• Citalopram (Celexa^®)

• Fluoxetine (Prozac^®)

• Escitalopram (Lexapro^®)

• Sertraline (Zoloft^®)

• Paroxetine (Paxil^®)

They may also suggest trying a serotonin and norepinephrine reuptake inhibitor (SNRI), which impacts both serotonin and norepinephrine, another neurotransmitter. Examples include duloxetine (Cymbalta^®) and venlafaxine (Effexor^®). 

Bupropion is another common option. Several studies show that this atypical antidepressant can produce improvements in sexual health in people prone to sexual issues from other medications that treat depression. Adding bupropion to Prozac or other SSRIs might lead to an improvement in sexual side effects or even make them go away completely. 

At the end of the day, it all comes down to safety. To be safe, take your meds as prescribed until you can talk to a healthcare provider about your concerns, and then work toward a solution together.

Antidepressant-induced sexual dysfunction can be frustrating to deal with. But you don’t necessarily have to choose between Prozac and sex drive.

There are other alternative medications and ways to change your dosage. There are even some products designed to help you with issues like vaginal lubrication. 

If you’re currently dealing with these effects of antidepressants, talk to a healthcare provider about them today and get the support you need in finding the right medication for your lifestyle. Not everyone has the same reactions to medications, and not everyone has the same needs or priorities. Getting the right treatment to help you live your best life is about tailoring to you as an individual.

If you’re ready to get help with your mental health or depression, or to sort out your existing medications, Hers can help. You can access medication support by setting up a consultation on our online psychiatry platform.