How do you treat decreased libido from SSRIs?  

Serotonin-1 agonism will revert it in about 60% of cases. You have a choice of adding buspirone at about 30 mg bid or going to vilazodone which has already an SR1 agonism. Some bupropion, not clearly understood at about 300 mg can also do it. Or if possible, use vilazodone, bupropion, or mirtazapine...

Our group has studied maca root as a natural treatment for antidepressant-induced sexual dysfunction. Maca is a perennial plant that grows in the Andes Mountains of South America and is traditionally used for nutritional and fertility enhancement. In two small studies, we found benefits from maca ro...

This answer is not going to be "the end all be all" but please consider checking a patient's serum testosterone level (both male and female). Try to check it in the morning as there is a diurnal curve. Order testosterone (Tot., Free, and SHBG). If ordering testosterone on a woman, be sure to order ...

I’ve found The Carlat Report outlines the most useful, non-biased, evidence-based strategies for managing this. Here is a link to a 2019 journal article on management: Strassberg, Carlat Publishing 2019.

I had good results with bupropion.

I have recently had success in side-stepping this issue with the use of fluvoxamine, which is also an SSRI that for some reason we have relegated only for use with OCD.

Decreased libido may not be what it seems. A female patient complained of sexual dysfunction from venlafaxine. We tried adding Wellbutrin and later Viagra and later switching to another antidepressant. But, after all that, her "sexual dysfunction" was cured when she left her husband and got a new pa...

I have had some success in reducing SSRI-related sexual dysfunction with prn cyproheptadine, 4-8 mg, one to two hours before sexual activity. Not recommended if use will be so frequent that it would interfere with the antidepressant effects of SSRIs.

Sexual activity is not equally important to everyone, and some would rather feel well. I always discuss patient values and ask them to choose (if they can). A surprising number of them prefer feeling well. I often ask myself whether libido reduction may be mechanistically related to improving depres...

For female post-menopausal patients vaginal estrogen is many times the key. It is NOT systemic, so no contraindication with breast cancer history or family history. Applied twice weekly, there are benefits in terms of revitalizing tissue, allowing for relief from dyspareunia as well as prevention of...

I haven't had much success with augmenting strategies for this problem. Sometimes I'll just switch to Lamictal if it is a big problem. Sometimes Viagra helps but many patients don't like the idea. For a couple of female patients, it seemed like dryness and initiating sex were the major concerns. Adv...

In my practice, I am generally avoiding augmentation. I would typically switch to something different from the agent that is identified as a libido and sexual activity suppressant. Multiple are already named above. For some reason, nobody mentioned Trintellix and the patient had some traumatic succ...

There are different answers for different patients. Vilazadone and Wellbutrin have helped some, and 48-hour drug (SSRI) holidays help others.