Abstract When it results from depressive illness, sexual dysfunction may improve as the patient responds to antidepressant therapy. However, many antidepressants can cause sexual side effects including loss of libido, lack of orgasm, erectile disturbances, and inhibition of ejaculation. These side effects from antidepressants are reversible, usually respond to a reduction in dosage, and should be the focus of physician-patient communication to prevent noncompliance with therapy. The types and mechanisms of sexual side effects from antidepressants are presented.