Best Libido Treatments for Women on Antidepressants

For women whose antidepressant lowered their sex drive, adding bupropion has the most trial evidence. In placebo-controlled trials, bupropion 150 mg twice daily improved desire, arousal and orgasm, although reviewers rate the evidence as low quality. Addyi (flibanserin) and PT-141 (bremelanotide, sold as Vyleesi) are FDA-approved desire treatments, but they were approved for low desire with other causes. Which one fits depends on what changed for you, your age and menopause status, and how you want to take it.

How common is low libido on antidepressants?

Very common. Sexual side effects have been reported with every class of antidepressant, and in population surveys more than a third of people taking them report a problem. Those numbers are probably low, because trials often don't ask about sex. When someone asks people directly, more of them report problems.

Desire is only one thing that can change. Antidepressants can also affect arousal and wetness. They can make orgasm delayed, weaker or missing, make orgasm painful, leave sex less satisfying or make sex hurt. Notice which of these changed for you, because that shapes which treatment fits.

Wanting your sex drive back is a good enough reason, whether or not you have a partner. When a woman on r/TwoXChromosomes posted that her doctor asked why she cared about her libido, one of the top replies was: "if you were a man, this would be a crisis." Another commenter wrote: "Libido is also tied to other types of drive and motivation."

Don't quietly stop your antidepressant to get your libido back. When sexual side effects lead people to skip their medicine, the condition it treats gets treated less well. Bring the side effect to your clinical team and to whoever prescribes your antidepressant.

What works best for low libido caused by antidepressants?

Adding bupropion to the antidepressant you already take has the strongest trial support so far. A 2025 review of trials in women on antidepressants covered 11 studies and 859 women aged 28 to 48. It compared add-on treatments with placebo, including bupropion, sildenafil, testosterone, maca root and saffron. Bupropion 150 mg twice daily (the sustained-release form) was the most effective of the drugs studied. Compared with placebo, it improved desire, arousal and orgasm. The reviewers rated the quality of the evidence as low.

One trial shows what that looked like for women on SSRIs who still had periods. Women who added bupropion scored 25.9 on a standard female sexual function scale, against 17.2 for women on placebo. Their desire rose 86.4% from where they started, and lubrication rose 69.2%.

The trials don't all agree. In a Cochrane review, two trials showed large benefits and a third found a smaller effect that was not statistically significant. Bupropion is the best-supported option so far, not a sure thing. In those trials it neither improved nor worsened depression scores, and women on bupropion dropped out at about the same rate as women on placebo.

Do Addyi or PT-141 work if you're on an antidepressant?

Both are approved desire treatments, but neither was approved for desire loss caused by an antidepressant. Here is how they compare with bupropion.

PT-141 is the research name for bremelanotide, the drug in FDA-approved Vyleesi. It works on melanocortin receptors in the brain, a different pathway from your antidepressant. Vyleesi is approved for premenopausal women whose low desire started at some point, shows up in every situation and causes real distress, and isn't caused by another condition, relationship problems or a medication. So its label doesn't cover desire loss from an antidepressant, and no trial here shows how it works for that.

In Vyleesi's two 24-week trials, women's desire scores improved and they felt less bothered by low desire. The number of satisfying sexual events did not differ significantly from placebo. Nausea is the main downside. 40% of women on Vyleesi had it, against 1.3% on placebo. It usually started within an hour and lasted about two hours.

Addyi is the only one of the two approved desire drugs that has been studied with antidepressants. In a 12-week safety study, 73 premenopausal women with mild or remitted depression took flibanserin and 38 took placebo, all on a steady dose of an SSRI or SNRI. Adding flibanserin was generally safe and well tolerated, with no increased risks. The study was too small and too short to show whether it improved desire, and its efficacy measures did not differ significantly from placebo.

Addyi's label carries a boxed warning: drinking alcohol close to your dose raises the risk of severe low blood pressure and fainting. Wait at least two hours after one or two drinks before your bedtime dose, and skip that night's dose after three or more. You can't take Addyi with moderate or strong CYP3A4 inhibitors (a group of medicines that raise flibanserin levels) or if you have liver problems. Grapefruit juice is also off the list.

Which libido treatment fits me?

• If desire, arousal and orgasm all dropped after you started your antidepressant, adding bupropion has the most trial evidence for that exact problem. Ask whoever prescribes your antidepressant about it.
• If you've gone through menopause, Vyleesi's label doesn't cover you. Since December 2025, Addyi's label covers women under 65 with this kind of low desire, including after menopause.
• If you have a glass of wine most evenings, Addyi's alcohol rules apply every night. Factor that in before you choose it.
• If you don't want another daily pill, PT-141 is used only when you want it. The approved dose is 1.75 mg, injected under the skin at least 45 minutes before sex, no more than once in 24 hours. The approved version's label does not recommend more than 8 doses a month. Our clinical team can prescribe PT-141 if it fits your goal.
• If you have high blood pressure that isn't under control, or heart disease, PT-141 isn't for you. The blood pressure rise after each dose usually settles within 12 hours.
• If you could get pregnant, use effective birth control while taking PT-141, and stop it if you think you're pregnant.
• Whatever you choose, tell your clinical team the name and dose of your antidepressant and everything else you take. Include supplements: Addyi's medication guide says not to take St. John's wort, ginkgo, resveratrol or cimetidine without talking to your doctor, and some medicines are ruled out completely.

You want to feel turned on again without giving up the antidepressant that's working. Take the quiz and tell us what you're on and what changed. Our clinical team reviews your answers and decides whether a libido treatment such as PT-141 fits your plan.