Medication Side Effects: Low Libido, Appetite Loss, & Startle Response - Risperdal, Lexapro, Clonazepam

Question
"I have a question possibly pertaining to medication. I have been experiencing a low libido and some other symptoms such as lack of appetite. I also have noticed that I can't feel an adrenaline rush or startle response when I get startled or scared. I have always had this before. I have been taking the Medications Risperdal(1MG) lowered recently from 2MG as well as 10MG of Lexapro and .5MG of Clonazepam. Could these be side effects from the medications or could they be related to some other condition such as low testosterone? I am a male 30 years old."  

Answer
Hi Mike,

Antidepressants and antipsychotics do cause sexual dysfunction. Risperdal is known to cause erectile dysfunction. The main problem is the diminished desire to have sex and during sex, there is a problem either getting hard, controlling the erection, and/or having an ejaculation/orgasm.  Lexapro can also cause erectile dysfunction in regards to having an stiff erection and/or orgasm. But it only occurs in less than 10% of individuals taking it. Clonazepam, on the other hand, is rarely found to cause erectile dysfunction. Less than 1% have such complaints but it is usually associated with other psychiatric behavioral factors and/or combination with other medications.

I do recommend that you DO NOT stop taking your medications. It is highly recommended that you speak to your psychiatrist regarding your erectile dysfunction. He/She may prescribe you Viagra/Cialis/Levitra to overcome the erectile dysfunction. It is very safe; however, there are side effects to Viagra/Cialis/Levitra. Thus, if you have any other medical problems that warrants safety concerns, such as heart problems, your psychiatrist will not prescribe it.

Your psychiatrist may refer you to a urologist if he/she is uncomfortable prescribing and managing your erectile dysfunction.

Regards,

John T, MD