T Nation

SSRI and T Level


Google search turned up nada. Anyone got some info? Just got put on an anti-depressant.


It will lower dopamine, raise prolactin and lower T.


SSRI’s make demands on the same liver enzyme pathways that also remove estrogens from the blood. That increases E2, lowers LH/FSH, T goes down, SHBG goes up, FT goes down. Ratio of E2:FT takes a double hit. SSRI’s also cause problems with sexual performance. Wellbutrin has the opposite effects. Doc’s are typically ignorant about brain meds.

Specific detail about one drug shows what info is available:

Sexual side effects

Like other SSRIs, sertraline is associated with sexual side effects, including arousal disorder and difficulty achieving orgasm. The observed frequency of sexual side effects depends greatly on whether they are reported by patients spontaneously, as in the manufacturer’s trials, or actively solicited by the physicians. There have been several double-blind studies of sexual side effects comparing sertraline with placebo or other antidepressants.[142] While nefazodone (Serzone) and bupropion (Wellbutrin) did not have negative effects on sexual functioning, 67% of men on sertraline experienced ejaculation difficulties vs. 18% before the treatment[142] (or 61% vs. 0% according to another paper).[51] Similarly, in a group of women who initially did not have difficulties achieving orgasm, 41% acquired this problem during treatment with sertraline.[51] A 40% rate of orgasm dysfunction (vs. 9% for placebo) on sertraline was observed in a mixed group in another study.[143] Sexual arousal disorder, defined as “inadequate lubrication and swelling for women and erectile difficulties for men”, occurred in 12% of patients on sertraline as compared with 1% of patients on placebo. The mood improvement resulting from the treatment with sertraline counteracted these side effects, so that sexual desire and overall satisfaction with sex stayed the same as before the sertraline treatment. However, under the action of placebo the desire and satisfaction slightly improved.[143]