Which antidepressant is commonly associated with sexual side effects?

Paroxetine is known for its significant association with sexual side effects among antidepressants. This is primarily due to its mechanism of action as a selective serotonin reuptake inhibitor (SSRI), which increases serotonin levels in the brain. While elevated serotonin can have mood-lifting effects, it can also lead to several sexual dysfunctions, including decreased libido, delayed ejaculation, and anorgasmia. These side effects are relatively common across SSRIs, but paroxetine tends to have a higher incidence compared to others in the class.

In contrast, while the other options like fluoxetine and sertraline may also cause some sexual side effects, they are generally reported to have a lower frequency compared to paroxetine. Amitriptyline, being a tricyclic antidepressant, also has a risk of sexual side effects, but its prevalence and the overall risk profile make paroxetine particularly notable in discussions about sexual dysfunction in patients being treated for depression.