Does Lexapro cause erectile dysfunction? (3+ findings)
By
Dr Drielli Vital-Fujii (PhD)
Author bio
Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.
Dr Drielli Vital-Fujii’s Highlights:
- Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.
- PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)
- Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.
- Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil
Professional Experience:
2012 – 2018 Project manager at University of São Paulo – Pharmacy Department
Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.
2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.
She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).
2018 – 2019 Faculdades Oswaldo Cruz
Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.
2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department
She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.
2023-2023 UniPiaget – University Center.
Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.
Education:
2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo
2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo
2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo
2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes
The leading publications of Dr Drielli Vital-Fujii are:
Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.
Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.
Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.
Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.
Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.
Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.
Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.
Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.
Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.
You can view some of Dr Drielli’s work below and links to her professional profile.
Orcid: https://orcid.org/0000-0001-9270-0466
Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii
Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000
Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR
Linkedin: linkedin.com/in/driellivital
Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital
CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists
In this article, we’ll discuss whether or not Lexapro causes erectile dysfunction, the mechanism by which it does so, scientific research and studies that support this association, possible Lexapro substitutes with a lower risk of doing so, and lifestyle changes to improve sexual function.
Does Lexapro cause erectile dysfunction?
Yes, Lexapro can cause erectile dysfunction.
Lexapro is the brand name of the medication escitalopram. It belongs to the SSRI (Selective Serotonin Reuptake Inhibitors) class of drugs. SSRIs treat depression by assisting in reestablishing the proper balance of serotonin in the brain.
Other hormones and neurotransmitters like testosterone and dopamine may be impacted by an increase in serotonin.
Due to the potential effects of testosterone on sexual desire and the role of dopamine in achieving climax, these changes in hormone levels may lead to sexual dysfunction, producing erectile dysfunction. (1)
What does research suggest?
Between 1997 and 2015, a study was conducted to assess the possibility of sexual adverse effects brought on by SSRI use. According to a 2003 survey, the sexual side effects of antidepressants and antipsychotics caused 41.7% of men and 15.4% of women to discontinue them.
Given that 40% to 65% of people who take SSRIs experience sexual dysfunction, this side effect can worsen depression and make it more difficult for people to take their medication as directed.
SSRIs are linked to a wide range of sexual adverse effects, with delayed release being the most prevalent. Reduced sexual desire, impotence (erectile dysfunction), and delayed or infrequent climaxes are further sexual adverse effects.
According to a clinical trial of 344 patients on SSRIs, paroxetine had the highest prevalence of sexual adverse effects, followed by fluvoxamine, fluoxetine, and escitalopram (Lexapro). Both escitalopram and fluoxetine had a similar rate of sexual dysfunction. (1)
As a result, we draw the conclusion that escitalopram (Lexapro) is a better SSRI than paroxetine and fluvoxamine for causing sexual dysfunction, such as erectile dysfunction, as a side effect of its use.
What should you do if Lexapro causes erectile dysfunction?
If you experience erectile dysfunction while taking Lexapro, speak with your healthcare provider right away. Your healthcare provider might decide to first lower your Lexapro dose to see if the symptoms go away.
Your healthcare provider may do the necessary examinations and diagnoses to rule out any underlying medical conditions that could result in erectile dysfunction, such as diabetes, MS (Multiple Sclerosis), spinal cord, and nerve damage.
A combination of medications, such as psychotropic drugs can cause erectile dysfunction as a side effect. Your healthcare provider might opt to adjust your medication doses to reduce erectile dysfunction.
There are some medications that cause erectile dysfunction, such as chemotherapy drugs, hypertension medications, and diuretics. Tadalafil (Cialis), may be prescribed by your healthcare provider to reduce erectile dysfunction while using these medications.
What are the alternatives to Lexapro if it causes erectile dysfunction?
If your healthcare provider adjusts your Lexapro dose and your erectile dysfunction persists, they may switch your medication to one with fewer side effects such as:
- NDRIs (Norepinephrine Dopamine Reuptake Inhibitors), such as bupropion, and atypical antidepressants, like mirtazapine are alternative treatments for patients experiencing Lexapro-induced erectile dysfunction. (1)
- Bupropion is an NDRI and has no serotonergic activity, so it does not have the same negative side effects as Lexapro, such as sexual dysfunction. (2)
- Mirtazapine blocks 5-HT2 receptors. As a result, there are fewer negative consequences that affect sexual function. Additionally, mirtazapine is a strong antagonist of the postsynaptic 5-HT3 receptors, which could increase climax. If you are taking Lexapro and developing erectile dysfunction as a side effect, mirtazapine is a good antidepressant that you can take in place of it. (3)
What lifestyle changes can help improve sexual function?
- Weight management: Managing your weight can help improve your sexual function. Overweight or obese patients are more likely to experience erectile dysfunction while taking Lexapro.
- Improved diet: A healthy diet plan can aid in weight management and enhance sexual performance.
- Exercise: The ability of your heart to pump blood can be improved by regular exercise such as walking and running, and improved blood circulation promotes blood flow during erections.
- Alcohol: Excess alcohol drinking worsens erectile function.
- Smoking: Quitting smoking improves your body’s ability to produce nitric oxide, which is necessary for maintaining blood flow throughout your body, including to the tissues in your penis. Nitric oxide helps to stiffen the penis and enhance sexual function. (4)
Conclusion
Erectile dysfunction is a side effect of Lexapro. According to what I know and what research has found. SSRI use is associated with more sexual side effects than other antidepressant classes.
If you experience sexual side effects while taking Lexapro, talk to your physician about switching to a different medication, such as bupropion or mirtazapine.
Additionally, modifying your way of living can enhance your sexual performance.
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References
1.-
Jing E, Straw-Wilson K. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. Mental Health Clinician [Internet]. 2016 Jul;6(4):191–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007725/
2.-
Stahl SM, Pradko JF, Haight BR, Modell JG, Rockett CB, Learned-Coughlin S. A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. The Primary Care Companion to The Journal of Clinical Psychiatry. 2004 Aug 13;06(04):159–66. Available from: https://pubmed.ncbi.nlm.nih.gov/15361919/
3.-
pi :: Psychiatry Investigation [Internet]. www.psychiatryinvestigation.org. [cited 2023 Oct 21]. Available from: https://www.psychiatryinvestigation.org/m/journal/view.php?number=552#:~:text=However%2C%20mirtazapine
4.-
Six lifestyle changes a man can make to improve sexual function [Internet]. University of Iowa Hospitals & Clinics. [cited 2023 Oct 21]. Available from: https://uihc.org/health-topics/six-lifestyle-changes-man-can-make-improve-sexual-function
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