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Key facts at a glance
- Zoloft (men)
- Erectile dysfunction 4% vs 1% placebo; ejaculation failure 8% vs 1%Zoloft (sertraline) label · DailyMed
- Lexapro (men)
- Impotence 2% vs <1% placebo; ejaculation disorder 12% vs 1%Lexapro (escitalopram) label · DailyMed
- Wellbutrin XL
- Impotence listed only in voluntary postapproval reports; no sexual dysfunction warning sectionWellbutrin XL (bupropion) label · DailyMed
- Sildenafil with SSRIs
- No effect of SSRIs on sildenafil levels in trial data; nitrates are contraindicatedViagra (sildenafil) label · DailyMed
- Compounded status
- The Mendoxa compounded tablet is not FDA-approvedFDA compounding Q&A
Does Wellbutrin cause ED?
Reported does not mean proven, and “less likely” does not mean impossible. The Wellbutrin XL (bupropion) label lists impotence, abnormal ejaculation and painful erection in postmarketing reports; voluntary reports cannot reliably establish frequency or causation. It also reports decreased libido in 3% versus 2% with placebo in immediate-release bupropion trials—those are not Wellbutrin XL erection-problem rates.
A 2002 cross-sectional study found sexual dysfunction in 22% of adults taking bupropion IR and 25% taking SR; the group of other antidepressants, including SSRIs, had rates of 36%–43%. This measured sexual dysfunction broadly, not ED alone, and was not a randomized comparison or a study of XL; the Wellbutrin XL (bupropion) label does not supply an XL ED percentage.
Timing matters, but it does not prove the cause: the Prozac (fluoxetine) label notes that the underlying psychiatric disorder can also explain sexual symptoms. For context, see performance anxiety and ED; if you take other medicines, bring those too and read our guides to lisinopril and ED and Adderall and ED.
What each antidepressant label lists for sexual side effects
Zoloft, Prozac and Lexapro can cause erection, desire and ejaculation changes. These are distinct symptoms in the Zoloft (sertraline) label, Prozac (fluoxetine) label and Lexapro (escitalopram) label; tell your provider which one is affecting you.
| Antidepressant label | Erection-related entry | Other sexual entries / population | What it does not tell you |
|---|---|---|---|
| Zoloft (sertraline), SSRI | Erectile dysfunction 4% vs 1% placebo in men (N=1316 vs 973), pooled controlled trials (Zoloft (sertraline) label) | Ejaculation failure 8% vs 1%; libido decreased 7% vs 2% (Zoloft (sertraline) label) | Whether sertraline caused your own symptoms |
| Lexapro (escitalopram), SSRI | Impotence 2% vs <1% placebo in men (N=407 vs 383) (Lexapro (escitalopram) label) | Ejaculation disorder (primarily ejaculatory delay) 12% vs 1%; libido decreased 6% vs 2% (Lexapro (escitalopram) label) | No adequately designed studies of sexual dysfunction with escitalopram treatment (Lexapro (escitalopram) label) |
| Prozac (fluoxetine), SSRI | Impotence is listed among the most common reactions (≥5% and at least twice placebo) in at least one studied condition (Prozac (fluoxetine) label) | Decreased libido 4% vs <1% in US depression, OCD and bulimia trials (not a men-only figure); symptoms occasionally persist after discontinuation (Prozac (fluoxetine) label) | A single erection-specific rate across all conditions |
| Wellbutrin XL (bupropion) | Impotence, abnormal ejaculation and painful erection appear only in voluntary postapproval reports (Wellbutrin XL (bupropion) label) | Decreased libido 3% vs 2% in immediate-release bupropion trials; no sexual dysfunction warning section (Wellbutrin XL (bupropion) label) | Frequency: postapproval reports cannot “reliably estimate their frequency or establish a causal relationship” (Wellbutrin XL (bupropion) label) |
Sources: Zoloft (sertraline) label; Lexapro (escitalopram) label; Prozac (fluoxetine) label; Wellbutrin XL (bupropion) label. Rates are each label’s own placebo-controlled figures, not head-to-head comparisons. Accessed Oct 23, 2026.
Which SSRI is best for avoiding ED? These separate trials cannot rank the drugs: the Lexapro (escitalopram) label cautions that label rates likely underestimate actual sexual side effects. Choose treatment with your prescriber based on both mental health and sexual symptoms.
Can you take Viagra or Cialis with Lexapro, Zoloft or Wellbutrin?
Taking an antidepressant does not automatically rule out ED treatment. Neither the Viagra (sildenafil) label nor Cialis (tadalafil) label lists an SSRI or bupropion contraindication. That absence is not proof that every combination is safe: the sildenafil label reports no effect of SSRIs on its pharmacokinetics in trial data, not clearance for every patient.
Flag fluvoxamine during the visit: the fluvoxamine label says fluvoxamine inhibits CYP3A4, and the Viagra (sildenafil) label and Cialis (tadalafil) label specify dosing precautions with strong or potent CYP3A4 inhibitors. A provider should also check for nitrates, blood pressure medicines and heart health before prescribing.
What has actually been tested? A 2003 randomized JAMA trial enrolled 90 men with depression in remission and antidepressant-associated sexual dysfunction: 54.5% taking sildenafil versus 4.4% taking placebo were much or very much improved. This was a sexual-function outcome, not a Mendoxa success rate; the Viagra (sildenafil) label is the ingredient reference, and this trial does not establish efficacy for Mendoxa’s compounded combination.
Compare options in ED medications compared and sildenafil vs tadalafil.
What each path includes
Choose the next conversation by the problem you want addressed. Bring a medication timeline to the clinician who prescribes your antidepressant; use an ED visit to ask about treatment suitability. You can raise both without deciding the cause yourself.
| Path | Question it addresses | What it includes | Boundary |
|---|---|---|---|
| Antidepressant prescriber review | Is my antidepressant part of the problem? | Timing of symptoms, dose and possible changes; prescribers are told to “inquire specifically about changes in sexual function during treatment” (Zoloft (sertraline) label) | Do not stop or taper on your own (Zoloft (sertraline) label) |
| ED assessment | What else could be causing ED? | Medical, sexual and mental health history, an exam and tests, including the medicines you take (NIDDK) | Depression itself can contribute; the Prozac (fluoxetine) label notes symptoms “may have other causes, including the underlying psychiatric disorder” |
| Standalone ED prescription | Can I add an ED medicine to my antidepressant? | Sildenafil or tadalafil if appropriate; the Viagra (sildenafil) label lists no effect of SSRIs on sildenafil levels | Nitrates are contraindicated (Viagra (sildenafil) label; Cialis (tadalafil) label); fluvoxamine inhibits CYP3A4 (fluvoxamine label) |
| Mendoxa 3-in-1 visit | Does the compounded tablet fit with my medicines? | Online intake that asks about every current medicine; Independent licensed providers review it; Prescription required | Compounded drugs are not FDA-approved |
Sources: Zoloft (sertraline) label; Prozac (fluoxetine) label; NIDDK diagnosis; Viagra (sildenafil) label; Cialis (tadalafil) label; fluvoxamine label; FDA compounding Q&A; Mendoxa ED care information. Accessed Oct 23, 2026.
For the bigger picture on causes and treatment, read the erectile dysfunction guide; if ED tablets have already disappointed you, see ED pills not working.
Could Mendoxa ED care fit you?
Online ED visit · Prescription required · Independent licensed providers · Not available in California
How to address ED without changing treatment on your own
Do not stop or cut back an antidepressant on your own. The Zoloft (sertraline) label advises patients “not to abruptly discontinue ZOLOFT and to discuss any tapering regimen with their healthcare provider,” and the Prozac (fluoxetine) label Medication Guide says “Do not stop PROZAC without first talking to your healthcare provider.”
- Name the symptom: difficulty getting or keeping an erection, reduced desire, or delayed ejaculation. The Zoloft (sertraline) label distinguishes these effects.
- Write the timeline: when symptoms began, when treatment began and any prescribed dose changes; the Prozac (fluoxetine) label asks clinicians to consider symptom timing and other causes.
- Choose the conversation: ask your antidepressant prescriber about treatment changes; start an ED assessment if you want to discuss erection treatment. Bring all medicines and supplements, as NIDDK’s assessment guidance recommends.
If you are having thoughts of suicide or are in crisis, call or text 988 or chat with the 988 Suicide & Crisis Lifeline; it is free, confidential and available 24/7.
Safety checks before ED medication
- Sildenafil and tadalafil are contraindicated with organic nitrates or riociguat (Viagra (sildenafil) label; Cialis (tadalafil) label).
- An erection lasting more than 4 hours needs immediate medical care (Viagra (sildenafil) label; Cialis (tadalafil) label).
- Stop and seek care for sudden vision loss or sudden decrease or loss of hearing (Viagra (sildenafil) label; Cialis (tadalafil) label).
- Common adverse effects include headache and flushing with sildenafil, and headache, indigestion and back pain with tadalafil (Viagra (sildenafil) label; Cialis (tadalafil) label).
- The APOKYN (apomorphine) label contraindicates use with 5HT3 antagonists such as ondansetron and warns about nausea and fainting.
Do not add another ED medicine to an existing treatment on your own: the Viagra (sildenafil) label and Cialis (tadalafil) label say combinations with other PDE5 inhibitors or ED therapies have not been studied and advise against such use. See ED medication and nitrates for more detail.
If ED is the problem you want treated now
Start the online visit to find out whether Mendoxa ED care is appropriate for you. Share your symptoms, health history and every current medicine, including your antidepressant; the Zoloft (sertraline) label and Prozac (fluoxetine) label ask that sexual changes be discussed with a clinician. Independent licensed providers assess suitability. Prescription required.
The tablet combines sildenafil, tadalafil and apomorphine; it is not FDA-approved. Ingredient references are the Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label; APOKYN is an injectable Parkinson’s treatment, and its label is not approval of this ED combination.
Learn about the compounded combination ED tablet, Mendoxa ED care or the Mendoxa home page before choosing. The online visit is the next step in assessing suitability; the costs below apply if prescribed.
Mendoxa ED plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine (APOKYN label). It dissolves under the tongue. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Tablets per month | 1-month total | Per tablet (1 month) | 3-month total | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
The 3-month total covers three months at the monthly tablet quantity shown.
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 23, 2026. The intake always shows the current price.
When anxiety, not the medicine, is the driver: performance anxiety and ED. Spotting the signs: ED symptoms.
When the mood itself is part of the problem: can depression cause ED?.
Related reading: gabapentin and ED.
FAQ
Does Zoloft (sertraline) cause ED?
It can. The Zoloft (sertraline) label reports erectile dysfunction in 4% of men vs 1% on placebo, plus ejaculation failure and decreased libido. Ask your prescriber about it rather than stopping, because the label advises against abrupt discontinuation.
Does Prozac cause impotence?
Impotence is a listed reaction in the Prozac (fluoxetine) label, which warns that SSRIs may cause erectile dysfunction, ejaculatory delay or failure and decreased libido. The label also notes that symptoms occasionally persist after stopping fluoxetine.
Can you take Viagra on Wellbutrin?
The Viagra (sildenafil) label does not list bupropion as a contraindication, and the Wellbutrin XL (bupropion) label does not list sildenafil. Ask a provider to assess the combination with your full medicine list; sildenafil is contraindicated with nitrates and riociguat (Viagra (sildenafil) label).
Can I take Cialis or Viagra with Lexapro?
Neither the Viagra (sildenafil) label nor Cialis (tadalafil) label lists escitalopram as a contraindication. A provider still needs to review your other medicines and health history; both labels prohibit use with nitrates. Tell the provider you take Lexapro and list every other prescription.
What is the best SSRI to avoid ED?
The Zoloft (sertraline) label, Prozac (fluoxetine) label and Lexapro (escitalopram) label all warn about sexual dysfunction; their separate trials cannot identify a best SSRI for you. Bupropion had lower broad sexual dysfunction rates in a comparative study, but it is not an SSRI and ED has been reported (Wellbutrin XL (bupropion) label). Discuss options with your prescriber.
How do you fix erectile dysfunction while on antidepressants?
Bring a symptom and medication timeline to your prescriber, and ask whether ED treatment is appropriate. A randomized trial supports sildenafil for some men with antidepressant-associated sexual dysfunction; that does not establish a result for everyone. Do not change your antidepressant yourself (Zoloft (sertraline) label); nitrates are contraindicated with sildenafil or tadalafil (Viagra (sildenafil) label; Cialis (tadalafil) label).
Ready to see if the Mendoxa ED tablet fits you?
From $129/month if prescribed · Cancel anytime · Available in 49 states (not California)
How we wrote this
Written by the Mendoxa editorial team · Sources: DailyMed/FDA. Medical facts on this page come from the FDA-approved labels on DailyMed and Drugs@FDA; each drug name links to its label. We checked the linked DailyMed labels and PubMed records on Oct 23, 2026. The table preserves each label’s terminology, placebo comparison and study population; separate trials do not provide a head-to-head ranking. Postmarketing reports do not establish frequency or causation (Wellbutrin XL (bupropion) label). Research on Viagra (sildenafil) is distinguished from evidence for the Mendoxa compounded product; compounded drugs are not FDA-approved.
Updated Oct 23, 2026. This page is general information, not medical advice. A licensed clinician decides what fits you.
References
- DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 23, 2026.
- DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 23, 2026.
- DailyMed: APOKYN (apomorphine hydrochloride) injection, label revised 6/2022. Accessed Oct 23, 2026.
- FDA (Drugs@FDA): VIAGRA (sildenafil) prescribing information, NDA 020895. Accessed Oct 23, 2026.
- FDA (Drugs@FDA): CIALIS (tadalafil) prescribing information, NDA 021368. Accessed Oct 23, 2026.
- FDA: Compounding and the FDA, questions and answers. Accessed Oct 23, 2026.
- DailyMed: ZOLOFT (sertraline) tablets and oral solution, Viatris. Accessed Oct 23, 2026.
- DailyMed: LEXAPRO (escitalopram) tablets and oral solution, AbbVie/Allergan. Accessed Oct 23, 2026.
- DailyMed: PROZAC (fluoxetine) capsules, Lilly/Dista. Accessed Oct 23, 2026.
- DailyMed: WELLBUTRIN XL (bupropion) extended-release tablets, Bausch Health. Accessed Oct 23, 2026.
- DailyMed: fluvoxamine maleate tablets, Apotex. Accessed Oct 23, 2026.
- Nurnberg HG et al. Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. JAMA 2003;289(1):56-64 (PubMed). Accessed Oct 23, 2026.
- Clayton AH et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry 2002;63(4):357-66 (PubMed). Accessed Oct 23, 2026.
- NIDDK: symptoms and causes of ED. Accessed Oct 23, 2026.
- NIDDK: diagnosis of ED. Accessed Oct 23, 2026.
- Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 23, 2026.
- Mendoxa ED intake: plan prices (term_options). Accessed Oct 23, 2026.
About Mendoxa
Mendoxa (mendoxa.co) is a US telehealth brand. Independent licensed providers (licensed clinicians in the LocumTele network) review each online visit, and prescriptions are filled by Rush Pharmacy, a licensed US pharmacy. Available in 49 states (not California).
- Prescription required. A licensed clinician reviews every visit and can say no. A prescription is not automatic.
- A compounded medicine is not an FDA-approved finished product (FDA compounding Q&A).
- Plans: 1 month or 3 months, from $129. If prescribed · Cancel anytime · Available in 49 states (not California).
Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.