Can Citalopram Cause Erectile Dysfunction?

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Citalopram and Erectile Dysfunction: What You Need to Know

Published: 14 October 2026

Citalopram erectile dysfunction is a recognised side effect of this commonly prescribed antidepressant. Citalopram belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression and anxiety. While these medicines are effective for mental health, they can affect sexual function, including the ability to get or maintain an erection. Understanding the link between citalopram and erectile dysfunction can help you discuss options with your doctor or pharmacist.

Does citalopram cause erectile dysfunction?

Yes, citalopram can cause erectile dysfunction in some men. SSRIs like citalopram work by increasing serotonin levels in the brain, which helps improve mood and reduce anxiety. However, higher serotonin levels can interfere with the chemical signals involved in sexual arousal and erections [1][2].

Sexual side effects are common with SSRIs. Studies suggest that between 25% and 73% of people taking antidepressants experience some form of sexual dysfunction, including reduced libido, difficulty achieving erections, or delayed ejaculation. The wide range reflects differences in how side effects are measured and reported. Not everyone will experience these problems, and the severity varies from person to person.

It is important to remember that depression and anxiety themselves can also cause erectile dysfunction. Sometimes it can be difficult to tell whether erection problems are due to the medicine, the condition being treated, or a combination of both. If you notice changes in your sexual function after starting citalopram, it is worth discussing this with your prescriber.

How does citalopram affect erections?

Citalopram affects erections through its action on serotonin, a chemical messenger in the brain. While increased serotonin can improve mood, it can also dampen the signals that trigger sexual arousal and the physical processes needed for an erection. Serotonin can reduce the release of dopamine and nitric oxide, both of which play key roles in achieving and maintaining an erection.

The effect is not the same for everyone. Some men notice problems within the first few weeks of starting citalopram, while others may not experience any sexual side effects at all. The dose can also make a difference—higher doses are more likely to cause problems. Other factors, such as age, overall health, and whether you have other conditions like diabetes or high blood pressure, can also influence how citalopram affects your sexual function.

If you are experiencing erectile dysfunction while taking citalopram, it does not mean you have to accept it as inevitable. There are several strategies that can help, and your prescriber can work with you to find the best approach for your individual situation.

Why you should never stop citalopram without medical advice

It is essential that you do not stop taking citalopram suddenly or reduce the dose on your own, even if you are experiencing erectile dysfunction. Stopping an antidepressant abruptly can lead to withdrawal symptoms such as dizziness, nausea, headache, irritability, and a return of depression or anxiety. These symptoms can be distressing and may be mistaken for a relapse of your original condition.

Your mental health is a priority, and citalopram has been prescribed to help manage your depression or anxiety. If sexual side effects are troubling you, speak to your GP or psychiatrist. They can discuss options such as adjusting the dose, switching to a different antidepressant with a lower risk of sexual side effects, or adding treatment for erectile dysfunction. Any changes to your medicine should always be made under medical supervision.

What are the options if citalopram is causing erectile dysfunction?

If you believe citalopram is contributing to erectile dysfunction, there are several options you can discuss with your prescriber. The right choice will depend on how well citalopram is controlling your depression or anxiety, how bothersome the sexual side effects are, and your overall health.

One option is to wait and see. Sexual side effects sometimes improve after the first few weeks as your body adjusts to the medicine. If the erectile dysfunction is mild and your mental health is stable, your doctor may suggest monitoring the situation for a few more weeks before making any changes.

Another option is to adjust the dose. Lowering the dose of citalopram may reduce sexual side effects while still providing enough benefit for your mental health. This needs to be done carefully and only under medical guidance.

Switching to a different antidepressant is also possible. Some antidepressants, such as bupropion or mirtazapine, are less likely to cause sexual side effects. Your prescriber can discuss whether a different medicine might be suitable for you. Finally, adding treatment for erectile dysfunction—such as a PDE5 inhibitor like sildenafil or tadalafil—can be effective and is often safe to use alongside citalopram. This allows you to continue your antidepressant while addressing the erection problems directly.

Can you take erectile dysfunction tablets with citalopram?

Yes, in most cases it is safe to take erectile dysfunction tablets such as sildenafil (Viagra) or tadalafil (Cialis) alongside citalopram. There is no major interaction between citalopram and PDE5 inhibitors, the group of medicines used to treat erectile dysfunction [3][4]. These tablets work by increasing blood flow to the penis when you are sexually aroused, helping you to get and maintain an erection.

PDE5 inhibitors do not interfere with how citalopram works, and citalopram does not significantly affect the levels or effectiveness of ED tablets. However, it is still important to have a consultation with a prescriber or pharmacist before starting treatment. They will check your full medical history, including any other medicines you take and any heart or blood pressure conditions, to make sure ED tablets are safe for you.

At Cured Pharmacy, all prescription treatments for erectile dysfunction are supplied only after an online consultation reviewed by a UK-registered prescriber. This ensures that the treatment is appropriate for your individual circumstances. If you are taking citalopram and experiencing erectile dysfunction, ED tablets can be a practical and effective option to discuss.

Important safety considerations

While PDE5 inhibitors are generally safe with citalopram, there are some important safety points to be aware of. You must never take ED tablets if you are using nitrate medicines (such as GTN spray or isosorbide mononitrate) for angina, or nicorandil, as the combination can cause a dangerous drop in blood pressure. You should also avoid using ED tablets with recreational drugs known as 'poppers' (amyl or alkyl nitrites) for the same reason.

If you take medicines for high blood pressure or an enlarged prostate (such as alpha-blockers like tamsulosin or doxazosin), you may be at increased risk of dizziness or low blood pressure when starting an ED tablet. Your prescriber will check this and may recommend starting on a lower dose. Always declare all your current medicines during the consultation, including over-the-counter products and supplements, so that the prescriber can check for any interactions.

Citalopram erectile dysfunction: lifestyle and other strategies

Alongside medical treatment, lifestyle changes can help improve erectile function while you are taking citalopram. Regular physical activity, a healthy diet, maintaining a healthy weight, and reducing alcohol intake can all support better erections. Exercise in particular improves blood flow and cardiovascular health, both of which are important for erectile function [1][2].

Smoking is a significant risk factor for erectile dysfunction, as it damages blood vessels and reduces blood flow to the penis. If you smoke, stopping can make a real difference to your erections as well as your overall health. Your GP or pharmacist can provide support and advice on quitting.

Stress and anxiety can also worsen erectile dysfunction, and these feelings may be linked to your mental health condition or concerns about sexual performance. Talking therapies, such as cognitive behavioural therapy (CBT) or counselling, can help address these issues. Some men find that couples therapy or sex therapy is beneficial, particularly if relationship difficulties are contributing to the problem.

It is also worth timing sexual activity carefully. Some men find that taking citalopram at a different time of day (for example, after sex rather than before) can reduce the impact on sexual function. Discuss this with your prescriber before making any changes to when you take your medicine.

When to see your GP about citalopram and erectile dysfunction

If you are experiencing erectile dysfunction while taking citalopram, it is important to speak to your GP or the doctor who prescribed your antidepressant. Do not suffer in silence or stop your medicine without advice. Your prescriber can assess whether the erectile dysfunction is related to citalopram, your mental health condition, or another underlying cause such as diabetes or cardiovascular disease.

Erectile dysfunction can sometimes be an early warning sign of heart disease or other health problems, so it is always worth investigating, especially if it is a new problem [1]. Your GP may arrange blood tests to check for conditions such as diabetes, high cholesterol, or low testosterone, all of which can contribute to erection difficulties.

If you have not yet tried treatment for erectile dysfunction, your GP can discuss whether PDE5 inhibitors or other options might be suitable. If you prefer the convenience of an online consultation, Cured Pharmacy offers a discreet, pharmacist-led service where you can discuss your symptoms and current medicines, and a UK prescriber will review your suitability for treatment.

Remember, erectile dysfunction is very common and highly treatable. With the right support and treatment, most men can find a solution that works for them, even while continuing to take citalopram for their mental health.

What to expect from an online consultation

An online consultation for erectile dysfunction is straightforward and confidential. You will be asked about your symptoms, medical history, current medicines (including citalopram), and any other health conditions. This information is reviewed by a UK-registered prescriber, who will assess whether ED treatment is safe and appropriate for you.

If approved, your prescription is sent to Cured Pharmacy, a GPhC-registered online pharmacy, and your medicine is dispensed and posted to you in discreet, unbranded packaging. If the prescriber has any concerns or needs more information, they will contact you. This process ensures that you receive safe, effective treatment tailored to your individual needs.

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 14 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 14 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 14 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 14 October 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.

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