Can you take Viagra with antidepressants? Usually, yes. In the label's studies, antidepressants of the SSRI and tricyclic groups did not change the level of sildenafil, the medicine in Viagra, and neither the Viagra nor the sertraline (Zoloft) leaflet lists the other. Sildenafil has also been tested as a treatment for the erection problems antidepressants can cause, and it helped in trials. Two things stay off limits: nitrates, and dapoxetine (Priligy), which is itself an SSRI.

Does Viagra interact with antidepressants?

No interaction is listed for the common ones. The European label's analysis of men in the trials found no effect on sildenafil levels from "selective serotonin reuptake inhibitors, tricyclic antidepressants" or beta blockers (EMA — Viagra; Viagra PI (Australia)). The Australian Viagra leaflet does not name any antidepressant among its interactions (Viagra CMI), and the Zoloft leaflet does not name any erectile dysfunction medicine (Zoloft CMI). Sildenafil is also not among the medicines healthdirect names as raising the risk of serotonin toxicity: more than one antidepressant, opioids, migraine medicines and recreational drugs (healthdirect — Antidepressants). Sertraline in particular: can you take Viagra with sertraline?

Can antidepressants cause erectile dysfunction?

Yes. healthdirect lists "sexual problems, such as a low sex drive" among antidepressant side effects (healthdirect — Antidepressants), and the Zoloft leaflet lists "impaired sexual function in males", adding that with SSRIs and SNRIs "in some cases, these symptoms have continued after stopping treatment" (Zoloft CMI). SSRIs can also cause delayed ejaculation in men (Australian Prescriber, 2013). Depression and anxiety can cause erection problems on their own, too (healthdirect — Erectile dysfunction). Whether sertraline's effect can last: can Zoloft cause permanent erectile dysfunction? Don't stop an antidepressant suddenly to fix it — ask your doctor how to reduce the dose (healthdirect — Antidepressants).

Does Viagra help with erection problems caused by antidepressants?

In trials, yes. In a 6-week trial of 90 men whose depression was in remission on an SSRI or similar antidepressant, 54.5% on sildenafil were much or very much improved, against 4.4% on placebo, and depression scores stayed in remission (Nurnberg et al., 2003). A Cochrane review of 23 trials found that for men with antidepressant-induced erectile dysfunction, "the addition of sildenafil or tadalafil appears to be an effective strategy", while calling the evidence "rather limited" (Taylor et al., 2013). Across the Viagra trials, 75% of men with depression reported better erections (EMA — Viagra). Medicines are not the only route: healthdirect lists psychological therapies and lifestyle changes for depression and anxiety too.

Can you take Viagra with anxiety medicines such as Xanax?

Neither label names the other, but they share a side effect. Alprazolam (Kalma, Xanax), used for anxiety and panic attacks, "may cause drowsiness, dizziness or light headedness"; alcohol adds to it; its leaflet lists "changes in sex drive" among side effects and warns that benzodiazepines "may lead to dependence" (Kalma CMI). Dizziness is a side effect of Viagra too, and the Viagra leaflet says not to drive or operate machinery if it happens (Viagra CMI). The two pairings are answered in can Xanax and Viagra be taken together? and Xanax with Cialis; anxiety as a cause of erection problems in is erectile dysfunction psychological?

Which combinations should be avoided?

  • Nitrates. Never with Viagra, whatever else you take (Viagra CMI).
  • Dapoxetine (Priligy). Dapoxetine, "a short-acting SSRI" for premature ejaculation, is "contraindicated with antidepressants including monoamine oxidase inhibitors, serotonin reuptake inhibitors, tricyclics and other drugs with serotonergic effects (tramadol, St John's wort and lithium)" (Australian Prescriber, 2013), and its own label rules it out for men with erectile dysfunction who use Viagra (Priligy PI): can you take Viagra and Priligy together?
  • Tramadol with an antidepressant. The Zoloft leaflet says not to take sertraline with tramadol, which "can cause an exaggerated response"; the Viagra label does not name tramadol (Zoloft CMI; Viagra CMI): can tramadol and Viagra be taken together?
  • Heavy drinking. The Zoloft leaflet advises avoiding alcohol, and the Kalma leaflet warns it makes you more "sleepy, dizzy or lightheaded" (Zoloft CMI; Kalma CMI).

The short answer

Viagra can usually be taken with an SSRI or tricyclic antidepressant, and it has helped men whose erection problems came from one. Tell the prescriber everything you take, keep an eye on dizziness if you also take an anxiety medicine, never combine Viagra with nitrates or dapoxetine, and never stop an antidepressant on your own. If you have thoughts of suicide and are at immediate risk, call triple zero (000); to talk to someone now, call Lifeline on 13 11 14 (healthdirect — Antidepressants). Every other combination: can Viagra be taken with other medicines? and our guide to taking Viagra or Cialis with other medicines.