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Clinical evidence

Bupropion

NDRI antidepressant·Medication side-effects · Sexual-dysfunction treatments

Effect across the cycle

DesireFacilitatory: Improves desire via dopaminergic and noradrenergic tone.
ArousalFacilitatory: Generally arousal-preserving or enhancing.
PerformanceFacilitatory: Low rate of erectile side effects; can improve function.
ClimaxFacilitatory: Preserves or improves orgasmic capacity.
ExperienceFacilitatory: Less blunting than serotonergic antidepressants.
MemoryNeutral: Not a memory factor.

Mechanism

Norepinephrine–dopamine reuptake inhibitor. Raises dopamine and norepinephrine in reward pathways, improving desire, arousal and orgasm, with a low rate of sexual side effects. Used off-label for hypoactive desire and to counteract SSRI-induced dysfunction.

Pharmacokinetics
Standard antidepressant dosing; benefit builds over weeks.
Reversibility
Beneficial profile; not a dysfunction-causing agent.

Sex differences & notes

Studied for orgasmic dysfunction in non-depressed women and for methadone-induced dysfunction in men.

Key sources

  • Thase et al. (vs venlafaxine)
  • PMC9886814 (women, meta-analysis)