The antidepressant unexpectedly caused a side effect of hypersexuality.

Medications from the group of selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, are frequently prescribed for the treatment of anxiety disorders and depression. These drugs act on the serotonergic system of the brain, increasing the level of serotonin—one of the key neurotransmitters that regulates many processes in the body, including emotions, mood, and overall well-being.

Like many other medications, SSRIs can cause various side effects, including those related to sexual health. Typically, these include decreased libido, anorgasmia, or erectile dysfunction, but in some cases, hypersexuality may occur. Such a rare instance was recently reported by specialists in psychiatry from a hospital in India. Their article was published in the Journal of Psychosexual Health.

A 25-year-old married woman sought medical help due to prolonged depression, sleep disturbances, mood declines, and suicidal thoughts. The symptoms developed after she discovered her husband’s infidelity, which also damaged their relationship.

The patient was diagnosed with severe depression without psychotic features and was prescribed to take escitalopram at a dose of five milligrams per day. Gradually, the doctor increased the dosage to 15 milligrams, as the woman’s condition improved after two months, although the symptoms did not fully resolve.

Within five days after the new prescription, the patient experienced hypersexuality, characterized by a sudden increase in libido, an overwhelming urge to masturbate, and fantasies about sex with strangers. Due to this sexual arousal, she sought intimacy with her husband despite their argument. All these unusual behaviors distressed the woman, leading to continued episodes of crying and thoughts of suicide.

Among the possible explanations, doctors considered mania and sexual obsession but found no supporting evidence. The woman's blood tests returned normal results. Consequently, the medical team conducted a test using the Naranjo scale, which indicated a potential link with the use of escitalopram. The patient was switched to mirtazapine, a different type of antidepressant, and was also prescribed a benzodiazepine antipsychotic in combination with psychotherapy. Over two to three weeks, the adverse reactions, including hypersexuality, resolved, and the woman felt significantly better.

Researchers noted that, unlike large controlled studies, rare cases of side effects do not provide reliable evidence to establish a causal relationship with the medication. Nevertheless, reports of such instances from medical practice are important as they draw attention to unusual drug reactions that may not manifest during initial clinical trials.