Mild NSFW warning: this post mentions sexual side effects of medication.

SSRIs are the most common type of antidepressant (examples are Prozac/fluoxetine, Zoloft/sertraline, Paxil/paroxetine).

If you have experience with them, do you think they’re a good idea?

I came across a paper about side effects which I haven’t heard discussed before. Many people know that SSRIs have sexual effects, but apparently they also affect fertility.

This paper describes SSRIs as “gonadotoxic”, leading to effects like “decreased sperm concentration and motility, increased [DNA] fragmentation, and decreased reproductive organ weights”.

The paper does say “this effect does seem to be reversible”, so if you stop SSRIs, your sex organs should apparently go back to normal. But still, some people are on SSRIs for long periods of time, right?

I would be interested to hear others’ thoughts, if you have any.

Edit: Thanks for the replies to this post, they’re interesting.

  • Jo MiranEnglish
    2•20 hours ago

    I have battled chronic clinical depression since 1989 and it is possible that I have been prescribed every SSRI ever at one point or another. Two have had pronounced sexual side effects but I cannot remember which did what any more, so I’ll forgo names altogether.

    The first, and most disturbing of all, gave me instant erectile dysfunction. I was in my thirties when I started the pill. After a few days my penis was dead to the world. What is sad is that it was really working on my depression and anxiety without the dreaded twitching. ED in my thirties was a non-starter (no pun intended).

    The second one I took for years and was in fact the last SSRI I took before I took myself off them entirely and started doing my own thing. On this pill I sort of had the opposite problem, but still a big problem. I could not only get an erection, I could effortlessly maintain it at full strength indefinitely. Well, hours for sure, and if I wanted it back, it was back. The negative side effect was a near complete inability to ejaculate. I could have passionate sex for hours at peak performance, but I could very rarely reach the finish line. As far as clinical effectiveness, the pill was adequate but not great. The combination of only slightly dulled symptoms, sexual trauma, and a virtually unlimited capacity to perform can lead to some very unhealthy behaviors.

    Just be mindful, listen to yourself, and make sure that what you are doing works best for you. Good luck.

    PS: During the time I was on the last pill I also suffered from acute and chronic insomnia. At my worst I was getting 90 minutes of light sleep in a 24 hour period. I do not mention it as a side effect of the SSRI because I think that was caused by a combination of factors. The pills could have been one of the factors though. I am not sure.