No major drug interactions are known to occur between sildenafil (Viagra) and antidepressants – meaning, all things being equal, it is generally safe to take both simultaneously.
In a 2003 study, sildenafil was shown to improve ED symptoms and overall arousal, ejaculation, satisfaction, and orgasm quality in men with antidepressant-related sexual dysfunction. Sildenafil demonstrated no serious side effects in the subjects who tolerated the PDE5 inhibitor well.
Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor, along with tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra), all of which can be prescribed by a healthcare provider to treat sexual dysfunction caused by antidepressant use.
The relationship between sildenafil and tricyclic antidepressants
Granted, while sildenafil doesn’t typically interact with antidepressants, one of its side effects may interact with a specific side effect of a particular type of antidepressant.
Certain antidepressants can cause a type of low blood pressure known as orthostatic hypotension, which typically occurs when you get up after lying down. Orthostatic hypotension symptoms like blurred vision or vertigo usually subside quickly. However, in some cases, OH symptoms can be more severe, which can cause a blackout or a sudden loss of consciousness.
Taking sildenafil may cause blood pressure to drop, while tricyclic antidepressants like amitriptyline and clomipramine are known to cause orthostatic hypotension.
Therefore, if you take sildenafil and a tricyclic antidepressant, your chances of developing this side effect may increase.
If your healthcare provider prescribes sildenafil and a tricyclic antidepressant simultaneously, they will most likely instruct you to take certain precautions, such as jumping out of bed as soon as you wake up. Rather, you should slowly get up and sit on the edge of the bed for several moments before you get up to start your day.
Sildenafil does come with precautions and risks you need to know about, so make sure to give your doctor a full and accurate medical history as well as a list of all your current medications so they can provide you with the best approach to avoiding potentially dangerous interactions.
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What types of antidepressants cause ED?
Certain antidepressants may lead to ED symptoms or sexual dysfunctions like a low sex drive. However, side effects may vary depending on the individual. Some people may experience side effects from taking a particular antidepressant, while some might not.
We’ve put together several lists of antidepressants known to cause ED as follows.
Selective serotonin reuptake inhibitors (SSRIs) like:
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Citalopram (Celexa)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
Serotonin-norepinephrine reuptake inhibitors (SNRIs), like:
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
- Venlafaxine (Effexor)
- Levomilnacipran (Fetzima)
Tricyclic antidepressants (TCAs), like:
- Doxepin (Sinequan)
- Imipramine (Tofranil)
- Amitriptyline (Elavil)
- Nortriptyline (Pamelor)
Monoamine oxidase inhibitors (MAOIs), such as:
- Tranylcypromine (Parnate)
- Selegiline (Eldepryl)
- Phenelzine (Nardil)
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Why do some antidepressants cause erectile dysfunction?
Antidepressants work by raising the bioavailability of chemicals in the brain that impacts mood, such as serotonin. The exact reasons why certain antidepressants cause ED is yet unclear. However, a theory that’s gaining traction is that a boost in serotonin may negatively impact dopamine and testosterone – leading to ED symptoms and a low sex drive.
What are some other ways to treat ED caused by antidepressant use?
Your healthcare provider may instruct several approaches to help manage your antidepressant-induced ED, such as the following:
- Dosage adjustments. Over time, your healthcare provider may adjust the dosage of your antidepressants. It might take a bit of time to get the perfect dosage that’s low enough to manage your symptoms without causing unpleasant side effects.
- Changing to a different antidepressant. Results may vary across a variety of antidepressants and individuals. Some men may experience sexual side effects with one antidepressant but not another despite belonging to the same category of antidepressants. Antidepressants that are linked to a lower likelihood of developing ED include mirtazapine and bupropion.
- Adding another antidepressant. Your healthcare provider may prescribe an antidepressant that doesn’t cause sexual side effects, such as bupropion, to complement your current antidepressant.
Implementing lifestyle changes. Simple lifestyle changes can go a long way in treating antidepressant-induced ED, such as getting regular exercise, eating a well-balanced diet, and quitting smoking and alcohol consumption are known to be beneficial in treating ED. - Taking herbal supplements for ED. Certain herbal supplements may help with ED despite the limited evidence. Some herbal supplements that may help with ED include saffron, ginseng, and yohimbe, to name a few. However, just as with taking ED drugs, it’s important to consult your healthcare provider before taking herbal supplements as they can interfere with not just maintenance medicines, but also with antidepressants.
The final word: if you’re taking an antidepressant and you’re experiencing sexual side effects such as ED or a low sex drive, it’s most likely safe to take sildenafil under the prescription and guidance of a qualified medical professional. In the end, it’s best to consult your healthcare provider as regards the sexual side effects you might run into when taking antidepressants to determine how to manage and treat any such symptoms moving forward.
