S/x on Dr/gs Reference
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Clinical evidence

ADHD stimulants (Rx)

Prescription stimulant·Medication side-effects · Sexual-dysfunction treatments

Effect across the cycle

DesireBiphasic: Raised at low dose; suppressed at higher dose.
ArousalBiphasic: Dopaminergic enhancement vs noradrenergic vasoconstriction.
PerformanceBiphasic: Erectile dysfunction can emerge at higher doses.
ClimaxInhibitory: Delayed orgasm/ejaculation at higher doses.
ExperienceMixed: Focus and drive vs over-stimulation.
MemoryNeutral: Not a primary memory factor here.

Mechanism

Methylphenidate blocks DAT/NET; amphetamine also releases monoamines. Bidirectional and dose-dependent: pro-libido and enhanced arousal at low doses or with pre-existing dysfunction, but decreased libido, erectile dysfunction and delayed orgasm at higher doses or in psychiatric populations.

Pharmacokinetics
Onset within an hour; effect tracks the dosing curve.
Reversibility
Reversible.

Sex differences & notes

Generally reversible; effect direction depends on dose and baseline.

Key sources

  • Pharmaceuticals 2025 systematic review