Antidepressants & Anxiolytics with Low Risk of Sexual Dysfunction

Antihistamines

• Atarax
• Mirtazapine (also a Tetracyclic drug)
• Mirtazapine can be stacked on top of an SSRI to reduce sexual dysfunction. The results are typically seen later after 4–8 weeks.
• Chlorphenamine might be able to reduce SSRI sexual dysfunction.

Azapirones

• Buspirone
• Buspirone can be stacked on top of an SSRI to reduce sexual dysfunction.
  Try taking 5-10 mg, 3-4 times daily, in addition to your SSRI.
• Tandospirone (probably  low risk of sexual side effects - do your research)

Atypical antidepressants

• Bupropion A.K.A Wellbutrin
• Wellbutrin can be stacked on top of an SSRI to reduce sexual dysfunction.
• Agomelatine
• Agolematine might be able to reduce SSRI sexual dysfunction.

Serotonin Antagonists 

• Vilazodone
• Vortioxetine

SNRIs

• Duloxetine
• (33.3% of duloxetine patients experienced sexual side effects compared to 43.6% of those receiving escitalopram and 25% of those receiving placebo).

MAOIs

• Selegiline (transdermal patch)

GABAergics 

• As I understand it, GABAergics do not cause sexual dysfunction.
  Click here for a list of all GABAergics.

Reducing Sexual Side Effects of SSRI Medication

Cabergoline
there is some evidence that it counteracts reduced libido and anorgasmia. It also has been suggested that it has a possible recreational use in reducing or eliminating the male refractory period, thereby allowing men to experience multiple ejaculatory orgasms in rapid succession, and at least two scientific studies support those speculations.

Nortriptyline 

Anecdotal evidence shows that Nortriptyline might be able to counter the sexual side effects of SSRI.

Ginkgo Biloba (240 mg per day)

"in an open trial of various formulations, ginkgo was found to be effective in 84% of patients with sexual dysfunction induced by antidepressants".

Cannabis

Cannabis is a strong aphrodisiac. If you search, you'll find plenty of self-reports of its aphrodisiac effects.

Sildenafil, Tadalafil, Vardenafil (Viagra, Cialis, Levitra)
Can be used for males who only suffer from erectile dysfunction. These drugs do not affect libido or pleasure, only erection.

Supplements that may increase sexual function

• Yohimbine
• Panax Ginseng
• Maca capsules
• L-Arginine
• Zinc
• Selenium
• L-Citrulline
• L-Ornitine
• Rhodiola Rosea
• Trigonella Foenum Graceum
• Niacine
• Terminalia Chebula Extract
• Mucuna Pruriens
• Urtica Dioica
• Muira Puama extract
• Silybum Marianum

What is the cause of sexual dysfunction with antidepressants? 

It is thought that 5HT2c receptor agonism, which is increased serotonin transmission by blocking SERT, is the cause of sexual dysfunction.

5HT2c antagonists are likely to block the effect of SSRI sexual dysfunction.

Prozac actually blocks 5HT2c, but not strongly.