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Vakul Aren
Vakul Aren, Doctor
Category: Medical
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Experience:  MBBS,DTM&H,34 years of experience
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Hello, what do you think the most effective antidepressant

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Hello, what do you think the most effective antidepressant is?

I was on Lexapro for a week, but stopped taking it because I couldn't have an orgasm on it.

Do you think I'll have that problem with any SSRI? What one's do you think are most successful for bad anxiety and slight depression? Thanks!

Hello Jeff,

There is no such thing as best effective antidepressant to be honest with you.

All antidepressants are more or less equally effective in treating depression / anxiety symptoms and mainly differ in terms of side effects profile.

Although SSRI antidepressants are the first line choice for treating depression and anxiety but all SSRI antidepressant can cause sexual dysfunction and this is the major draw back of this class.

Bupropion (Wellbutrin) and Mirtazapine are two such antidepressants which usually does not cause sexual dysfunction and can even counteract the sexual side effects caused by SSRI antidepressants.

So in your case, there can be two possible options about which you can discuss with your doctor -

  • Continue Lexapro and ask your doctor to add either Bupropion (if you also have associated symptoms such as fatigue, low energy, sleepiness) or Mirtazapine (if you have associated insomnia and experiencing gastrointestinal side effect with Lexapro)
  • Start either Burpopion or Mirtazapine as a monotherapy. Bupropion is comparatively not very effective in treating anxiety disorder.

I hope this helps, please fell free to discuss further if you have any other query.



Kind regards



Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2229
Experience: MBBS; MD
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Most SSRIs have sexual side effects which may be depressing.They include lowered libido,weaker erections or inability to sustain a erection in males,lack of engorgement and lubrication in women and lack of orgasm.These side effects occur with almost all SSRI/SNRIs including Zoloft(sertaline)/Effexor(venlafaxine)/Duloxetine as also others to a extent of 50-70%.These drugs are excellent for anxiety and depression but unfortunately tend to cause these side effects.Use of Buspirone(Buprinion/Trazodone/ (Desyrel/Trazonil) has bee found effective for both anxiety and to a large extent reduction in sexual side effects.Trazodone is a atypical antidepressant and hypnotic and has very little sexual side effects.You can discuss the matter with your doctor/PCP.
Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3518
Experience: MBBS,DTM&H,34 years of experience
Vakul Aren and other Medical Specialists are ready to help you