T Nation

Antidepressants and TRT

Hey… so i suffer from an anxiety disorder and need to go on an antidepressant to treat it. I am afraid of the side effects, namely weight gain and sexual side effects i.e difficulty to achieve orgasm. I have also read that anti depressants lower test levels.

So does anyone know if being on trt and taking anti depressants is safe and if so which anti depressants are safer or have less sides? Anyone here taking anti depressants?
I am very hesitant to go on them because im worried im going to gain weight or mess up my progress or get other side effects.

Im sure someone here is on them and can share some insight.

Thanks in advance

I’m not, but patients are. It’s tough. Those I see on antidepressants, men and women, are in the office for the reasons people avoid antidepressants. So, in my little world, I see the bad side of it as those doing well and happy are not showing up in the office to tell me their story. Usually, TRT helps but sometimes you just can’t overcome the side effects. Yes, you could try TRT on antidepressants.

Sometimes, guys are depressed because they are fat, out of shape, tired all the time, having marital problems because of their poor libido and failing at work. I’d be depressed too. Testosterone can take care of all of that.

However, you said anxiety. As mentioned, it’s tough. Testosterone can help with anxiety, and it can exacerbate it. I don’t know your situation, obviously, maybe you could get your hormones checked and look into that prior to the other approach. I don’t know, sometimes, people need ADs and there is no choice.

Good luck.


FWIW I got off of SSRIs once I got onto trt.

Be aware to not let your E2 and androgens go up or you can end up being depressive. I had passe thru it while on test.

Why do you NEED to go on an antidepressant? Plenty of people suffer from anxiety, and don’t use antidepressants.

Be careful. Antidepressants can be nasty stuff. My son was on an antidepressant, which actually made him suicidal. The very medicine that was supposed to help his anxiety and depression, made him violently angry, and more depressed.


I have GAD too. I’ve taken 4 different SSRIs over the years. Some did affect libido but I found one that doesn’t. You may have to try a few to see what works for you. Lexapro was the most friendly for me.

I don’t want to fear monger, but you should at least educate your self on the potential lasting side effects that SSRIs can cause. I developed PSSD from antidepressants — a condition which steals a lot more from you than just your sexuality. While I have little anxiety these days (that’s why I started them as well), my emotional range is still very limited and I suffer from other nervous system issues.

Do antidepressants have their place? I would still, in spite of everything, say yes — but I would really keep them as a last line of defense. Also, some ADs are less known to cause lasting issues than others. Definitely avoid antipsychotics and SSRIs if you can.

Before getting on any drug, I would get full blood work. Funny how psychiatrists run a “medical model” of mental illness but never check for any underlying pathologies (hormones, thyroid, d3, vitamin deficiencies, etc.).

If all checks out normal, then you may consider lifestyle changes, therapy, TMS, meditation, etc.

I would save drugs as the last line of defense, but In my opinion, here are the safest anxiolytics — at least with respect to returning to normalcy if you ever discontinue them.

Buspirone, MAOIs, vortioxetine, pregabalin, and mirtazapine are some drugs less associated with lasting negative effects, from what I’ve read. If your anxiety is strictly situational, occasional benzos or beta blockers may be the best way to go.

Propanolol is exactly what im using now but its a bandaid solution. Also…i know ad are too but they will help more than the beta blockers.

My anxiety started after quitting smoking and weed cold turkey…years ago. And its never left. I also have a feeling my years of ecstacy abuse in my younger years messed up or depleted my serotonin levels… The symptoms are too bothersome to ignore and i want to be able to feel free and not worry about sudden profuse sweating or crazy back pain and soreness anymore…

I will try some suggestions here like lexapro…


I wouldn’t recommend lexapro, but you can do your own research.

Good luck.

Not a fan of lexapro , it def stopped anxiety in its tracks but made me so unbelievably tired

Have you tried THC or CBD since to see if that helps your anxiety?

I also have experience with the constant whore life companion that is anxiety.

I’ve found TRT can be a double edged sword with anxiety. Too much of a dosage can increase my anxiety. Once natural production shut down, too little of a dose can also increase it. A protocol change can cause some increases depending on what it is. Strangely, going from once weekly IM to twice weekly caused a noticeable increase in anxiety for no particular reason.

These are all my experiences, will be different for each.

Must note, when it’s a good dose working for me, it did decrease anxiety a lot. Some folks no longer need SSRI’s when on a good dose of T.

I wouldn’t worry about concurrent SSRI use, tons of people are on both. There is a significant correlation between hormone problems and various mental illnesses, particularly anxiety and depression. 50% of the patients at my TRT clinic are on some manner of SSRI for the above.

Further, my local doc started off label prescribing low dose TRT to both men and women who experience SSRI induced sexual side effects. On the flip side, he also off label scribes low dose SSRI’s for premature ejaculation.

It’s a drug filled world.

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I have been on generic lexapro for years. I found the minimal dose I needed to see an effect was 5mg per day, and that certainly decreased any sexual side effects. At 10mg which is the standard starting dose, I had a hard time reaching climax. I started TRT six months ago, and found that it helped my anxiety, now I do 5 mg of lexapro 3x per week. TRT actually helped decrease the number of monthly migraines I was having as well, which can also be caused by low T, I researched that later and was quite surprised. So, in my experience, I have been on a low dose of antianxiety meds, and TRT helped get rid of any additional sexual side effects noted. There are times my anxiety does fluctuate more, but I can’t pin down (pun intended) what type of TRT dosing frequency works best yet.

Im a few months into bupropion but thats not usually given for depression with anxiety since it kind of ramps you up. Good luck.

Thx for all the replies guys. What i am hoping and looking for is a ssri or anxiolytic (no benzos took those b4 and those gave me really bad rebound anxiety and panic attacks and the only thing that would help was more benzos…took forever to get off them. Was hell) that gives me more energy and does not make me tired or sluggish and gain weight and eat more and i also dont want to lose my inability to cum…

I guess i just gotta be a guinea pig and keep trying till i find one that works…thats a situation i was trying to avoid but i guess i got no choice.

Aren’t benzos just the worst. Literally the one thing that works for anxiety all the time, every time, dirt cheap, fast… and also addictive as fuck with some weird after effects for a lot of people.

My experience with SSRI’s was limited, but you are correct, just keep trying the different ones until you find the one that works for you at the lowest dosage possible.

You can also look into various BP medication, as they are gaining popularity for anxiety.

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I feel your pain man. I’m on Busiprone and Zoloft for anxiety. I also take Propranolol to help with the physical symptoms.

I still get panicky but it’s “manageable”.

The drugs are a band-aid…and I’ve been using this band-aid for 10+ years now. I’m starting to turn the corner and get my shit together.

Get blood work to cover the obvious things that might make one jumpy. Next, chill on the booze if that’s your thing. It’s a tough one, since I love beer, but I find it makes my anxiety worse especially if I’ve had too many.

Basically, if your body is healthy, that is probably way better than SSRI’s…of course with some exceptions.

TRT is helping my well-being and making me feel more confident and “manly”. It hasn’t helped or hurt my anxiety.

It’s going to be a long journey for me but I’m finally getting my ass in gear.

If you genuinely need TRT I’d say do it. Just go slow and take your time.

I always read this and it mystifies me. I used benzos for years, quit cold turkey, and it was like nothing happened. It’s weird how much variations there are from one person to another.

I’ve always read they are addictive but I’m prescribed them and maybe use 1-2x a month. Never found it habit forming for me. My GAD is mostly manageable on the SSRI.

You bet, extremely subjective to the physiology of the person taking them. For some, not a problem. For others, harder to quit than heroin.