Does Seroquel Affect Sex Drive? What the Antipsychotic Studies Actually Show

The link between Seroquel and sex drive is real but smaller than for most antipsychotics: quetiapine sits at the low end for sexual side effects, yet many people on it still report a sexual problem. One meta-analysis grouped quetiapine with the drugs linked to rates of 16% to 27%, against 40% to 60% for the drugs at the other end. In a small 6-week randomized trial, 16% of people on quetiapine reported sexual dysfunction when asked directly, against 50% on risperidone. The illness counts too: in unmedicated psychosis, rates ran from 16.8% to 70%.

Figures from Serretti et al. 2011 (PMID 21191308), Bobes et al. 2003 (PMID 12623765) and Montejo et al. 2010 (PMID 20214720). All three draw on observational data, so every figure here is an association.

Is it the Seroquel, or is it me?

People type that question late at night, and the straight answer is probably some of both, with a different split for everyone. Quetiapine is prescribed for bipolar disorder, schizophrenia, depression, anxiety and, off-label, for sleep, and each of those can flatten desire by itself. So the first job is working out how much flatness was there before the pill.

For psychosis, there is a direct look at this. Vargas-Cáceres and colleagues (2021) reviewed studies of people who were either never medicated or had been off medication for at least 3 weeks. Across 5 papers and 770 cases, sexual dysfunction ranged from 16.8% to 70%, and it was 50% in people at ultra-high risk, before psychosis had even started. Rates were higher than in healthy controls. The review is small and the studies mixed, so the range is wide. Still, sexual problems often come before the first prescription.

Bipolar disorder tells a similar story. Cañada and colleagues (2026) reviewed 37 studies covering 8,724 people with bipolar disorder. Reported rates of sexual dysfunction ran from 14% to 91%, depending on the sample and the medicines. Desire was the domain hit most often, and people with bipolar disorder had poorer sexual function and satisfaction than healthy controls. The review gives no pooled figure and no split between the illness and the drugs, so it cannot tell you what share is yours to blame on Seroquel. If you are on a mood stabiliser as well, what the lamotrigine studies show covers the other half of a common pairing.

Depression pulls the same lever. Depression and low libido goes through how much of the drop belongs to the low mood itself. If you take a small dose for sleep and feel tired all the time, the tiredness may be doing more than any direct effect on desire. Trazodone and sex drive covers the other sleep medicine people often land on, with its own quite different evidence.

How often antipsychotics do this, by the numbers

Sexual side effects on antipsychotics are common and often go unmentioned. Montejo and colleagues (2010) ran a multicentre study with 18 investigators and 243 sexually active adults with schizophrenia or another psychotic illness, all on long-term antipsychotics. Overall, 46% had sexual dysfunction on a structured questionnaire: 50% of men and 37% of women. Only 37% of those people raised it on their own. Among those with a problem, 32% tolerated it poorly. Using olanzapine as the reference, risperidone carried an odds ratio of 7.45 (95% CI 3.73 to 14.89). This was a cross-sectional snapshot with no before-treatment data, so it cannot show which drug caused what, and it gives no separate quetiapine figure.

Young and colleagues (2015) pulled together 53 studies on nine kinds of antipsychotic side effects, sexual problems among them. In their summary, 50% of men noted sexual dysfunction, against 25% to 50% of women, while raised prolactin was more common in women. Taking several antipsychotics together went with more side effects, and longer use with more severe ones. Side effects, they note, are often never measured in any systematic way, which fits Montejo's finding that most people wait to be asked.

Bobes and colleagues (2003) gave the clearest drug-by-drug picture from ordinary clinics. The EIRE study saw 636 outpatients with schizophrenia, each on a single antipsychotic for at least 4 weeks. Sexual dysfunction was reported by 38.1% on haloperidol, 35.3% on olanzapine, 43.2% on risperidone and 18.2% on quetiapine. Other reproductive side effects ran 11.7% on risperidone against 2.7% on quetiapine. The lower quetiapine risk held for short-term use, under 12 weeks; longer-term data were missing. It was a single-visit survey using a side-effect checklist, so treat it as a pattern. If you are on an antidepressant alongside Seroquel, SSRIs and the libido drop is worth reading, because those drugs carry their own well-measured effect on desire.

Seroquel and sex drive next to the other antipsychotics

The pooled data put quetiapine at the gentle end. Serretti and colleagues (2011) ran a meta-analysis of studies that measured sexual side effects properly and gave separate data for each drug. Quetiapine, ziprasidone, perphenazine and aripiprazole were linked to relatively low rates, 16% to 27%. Olanzapine, risperidone, haloperidol, clozapine and thioridazine were linked to higher rates, 40% to 60%. That split roughly follows whether a drug raises prolactin. The caveats are real: several study features shifted the rates, and the authors say plainly that it is hard to separate what the drug does from what the illness does. If aripiprazole has come up as an option, what the aripiprazole studies show covers that drug in detail.

The head-to-head trials are small, but they are randomized. Knegtering and colleagues (2004) assigned people with schizophrenia or a related illness to quetiapine or risperidone for 6 weeks. On a direct interview, 4 of 25 on quetiapine (16%) reported sexual dysfunction, against 12 of 24 on risperidone (50%), P = 0.006. Only 6 people (11.7%) mentioned it without being asked. Mean prolactin was 13.8 ng/mL on quetiapine against 57.7 on risperidone. The trial was open-label and small, and it ran 6 weeks.

Kelly and Conley (2006) ran the one double-blind comparison, and it is a useful reality check. For 12 weeks, 27 people with schizophrenia took risperidone, quetiapine or fluphenazine, an older drug. Prolactin at the end was lowest on quetiapine by a wide margin. The share reporting sexual dysfunction did not follow the same order: 42 and 50% on risperidone and quetiapine. In the fluphenazine group, 78% reported it. Finishing-phase items improved most on quetiapine (p = 0.033), and 40% on quetiapine felt better about their sexuality than on their previous medicine, against 55% on risperidone and 13% on fluphenazine. Only 6 people took quetiapine, so one person changes the picture by a big margin.

Two observational studies point the same way as the pooled data. Byerly and colleagues (2006) rated 238 outpatients once, 57 of them on quetiapine. On a scale where higher is worse, adjusted scores were 17.80 on quetiapine, 19.69 on risperidone and 20.34 on olanzapine. Quetiapine differed from olanzapine (p = .04), the gap with risperidone was not significant (p = .17), and all three groups had a moderately high degree of sexual dysfunction. People were not randomized. Nagaraj and colleagues (2009) compared 25 people on quetiapine with groups on risperidone and olanzapine and 30 healthy volunteers. Impairment in at least one sexual domain ran 96, 88, and 90% for risperidone, quetiapine and olanzapine, with no significant difference between the drugs. Among the healthy volunteers, 23% reported the same. It was a small cross-sectional study, and it shows that "lower" can still mean most people.

The trials outside psychosis look calmer, and the way they measured it matters. In a generalised anxiety trial of 873 people, Bandelow and colleagues (2010) found sexual dysfunction reported as a side effect by 0.9% on quetiapine XR 50 milligrams, 1.8% on 150 milligrams, 2.3% on placebo and 7.4% on paroxetine. Those were volunteered reports over 8 weeks, with no sexual questionnaire. Clayton and colleagues (2014) pooled 6 placebo-controlled depression trials that did use a questionnaire, and quetiapine XR came out non-inferior to placebo (difference 0.16, 95% CI -0.59 to 0.92). Several authors had worked for the drug's maker, and most analyses were post hoc. For Latuda (lurasidone), one 6-week trial in depression with mixed features, 109 people on the drug and 100 on placebo, found a shift from normal to abnormal sexual function in 1.9% on the drug against 4.3% on placebo, in an analysis run by authors from the maker.

Prolactin, sedation and weight: the three mechanisms with data

Prolactin is the mechanism everyone names, and the evidence for it is real but messier than the forums suggest. Many antipsychotics raise this hormone, and reviews tie raised prolactin to a higher risk of sexual problems. Quetiapine barely moves it: 13.8 against 57.7 ng/mL on risperidone in Knegtering's trial, and the lowest endpoint level of three drugs in Kelly's. The pooled rates broadly follow that split too. Yet Westheide and colleagues (2008) followed 102 inpatients with schizophrenia on quetiapine or risperidone for 4 weeks and found that prolactin did not correlate with sexual dysfunction at all. People on quetiapine reported less severe impairment, and better emotional regulation went with better sexual function. It was not randomized.

De Hert and colleagues (2014) reviewed the whole question and reached a careful verdict: long-term data are scarce, studies use such different measures that reliable drug comparisons are impossible, and most cannot separate the drug's effect from the illness. Low prolactin probably explains part of why quetiapine sits in the lower band. It cannot explain all of it, because people on quetiapine still report problems.

Sedation and weight are the other two mechanisms with data behind them. In the anxiety trial, sleepiness and fatigue were among the most common side effects of quetiapine XR. McIntyre and colleagues (2009) reviewed the depression registration trials and named weight gain, disrupted blood sugar and fats, and sedation or sleepiness as the major limitations of quetiapine XR; every study in that review came from the maker. Young and colleagues (2015) found longer use went with more severe side effects, such as a higher BMI. None of these papers measured whether sleepiness or weight change explains a drop in desire. What they show is that both are common on this drug. Being tired all the time and feeling unlike yourself in your body both weigh on wanting. Sleep, libido and testosterone goes through how heavy that sleep effect can be, and stress killing your sex drive covers the load that often sits underneath.

What the switch and add-on studies found

If sexual side effects are the problem, the obvious idea is to switch to a lower-prolactin drug. The evidence for that is thinner than you would hope. Byerly and colleagues (2008) ran a double-blind pilot trial: 42 outpatients with sexual problems on risperidone were randomized to stay on it or switch to quetiapine for 6 weeks. There was no significant difference between groups. Scores on a scale where lower is better were slightly lower after the switch at week 2 (21.27 against 22.18) and week 6 (18.51 against 20.53), and nearly identical at week 4 (20.01 against 20.15). It was a pilot, small and short.

The Cochrane review by Schmidt and colleagues (2012) found only 4 trials covering 138 people. For switching from risperidone to quetiapine, it found no evidence of benefit (n = 36, MD -2.02, 95% CI -5.79 to 1.75). One small open-label trial found improvement after switching to olanzapine (n = 54, MD -0.80, 95% CI -1.55 to -0.05), and one trial of 32 men found sildenafil helped erection outcomes. The reviewers said well-designed trials were urgently needed. Nunes and colleagues (2012) counted 31 studies, 25 of them open-label with no control group. The randomized add-on trials that showed improvement used sildenafil and aripiprazole; selegiline and cyproheptadine did not help. Switching to quetiapine was tested in 2 randomized trials, and 1 improved its main outcome while the other did not.

The switch evidence leans toward low-prolactin drugs, and it is thin. That is a conversation for your prescriber. Stopping on your own is the one move none of these studies support.

Nineteen papers, and what each one can tell you

The research splits into three piles. One asks how common sexual problems are on antipsychotics. One compares quetiapine with other drugs. One asks what helps. None of them can tell you, personally, whether your flatness is the medicine, the illness, the tiredness or the life around it.

What to bring to your prescriber

The fastest way to a useful answer is to walk in with the question already shaped. Bring these six things.

1. When the change started: before Seroquel, after it began, or after a dose change. Note what your mood and sleep were doing at the time.
2. What exactly changed. Is it wanting, or is it the physical side, or is it that you are too tired to care? Those point in different directions.
3. The fact that most people never raise it. In one study only 37% of those with a sexual problem mentioned it unprompted, so saying it out loud is normal and useful.
4. The ranking: in pooled data quetiapine sits in the lower 16% to 27% band, so a switch is not automatically a gain. Ask what else could be adding to it.
5. Your other medicines, including any antidepressant or mood stabiliser, since several drugs together went with more side effects in the review of 53 studies.
6. If you are thinking about a supplement, bring the bottle and ask directly.

"I've tried everything"

You may have waited it out, pushed through the tiredness, or quietly given up. That exhaustion is fair, because the tested options are few. The Cochrane review found only 4 trials covering 138 people. The one double-blind switch pilot to quetiapine found no significant difference. The broader review counted 31 studies, most of them open-label with no control group. What has never been in a trial is the stuff that usually does the heavy lifting: steadier sleep, a lighter load, a stable mood, and time with a partner where nothing is expected. If your bloodwork keeps coming back normal and you still feel nothing, numbers fine, still flat is the place to start. What HSDD means covers when low desire becomes a pattern worth naming to a clinician in its own right.

The everyday levers, and where a botanical fits

Start with who this section is not for. NUUD's own label carries a caution, quoted word for word: avoid use if you are on blood pressure medication, have cardiovascular, renal, or pulmonary conditions, or if you are sensitive to any of the ingredients. Quetiapine is often prescribed alongside other medicines, and weight and blood-sugar changes are among its known limitations. If any of that applies to you, the label sentence is your answer. Talk to your prescriber first and bring the label.

A few ordinary things move desire in most people, and the free ones do more work than the internet admits.

• Sleep, in quantity and quality. A sedating medicine can leave you tired all the time, and broken sleep flattens desire on its own.
• Movement you can keep up. Exercise and libido covers the wider picture, and it helps with weight too.
• A stable mood, as the first lever, since the medicine is doing real work there and mood carries much of the load.
• Time and safety, with a partner or on your own, with nothing expected at the end.
• A botanical supplement, if you want one, as the smallest lever on the list.

NUUD is a botanical supplement built around desire in general; it does nothing for bipolar disorder, schizophrenia, depression, anxiety, or the side effects of Seroquel or any antipsychotic, and it has no role in managing any medical condition. The formula is anchored by the NUUD Mushroom Complex™, with Muira Puama, Boiled Rehmannia Root, Tribulus Terrestris, and Piper Nigrum for absorption, and it takes effect in roughly 30 to 60 minutes. If you take blood-pressure medication or have a heart, kidney or lung condition, the label says no, and your prescriber decides the rest. If your prescriber has read that label and has no objection, that is what our women's libido gummies are for. There is a men's version.

Nothing is wrong with you

Think about why Seroquel was prescribed. For most people it was to hold back mania, psychosis, deep depression, or nights without sleep. That work is invisible when it goes well, and worth protecting. On quetiapine, fewer people report sexual problems than on many other antipsychotics, and in a large clinic survey it was 18.2% against 43.2% on risperidone. Yet the illnesses it is prescribed for carry their own weight: up to 70% of people with untreated psychosis and up to 91% in some bipolar samples reported sexual dysfunction. A quiet drive here is a known, common side of both the medicine and the illness. It says nothing about your worth to a partner. You just want to feel normal again. That is a reasonable thing to ask for, and it starts with saying it out loud to someone who can see the whole picture. Low libido in women and low libido in men cover the wider causes that sit alongside any medicine.

Keep reading

• Does Abilify affect sex drive?
• Does lamotrigine affect sex drive?
• Does trazodone affect sex drive?
• Depression and low libido
• Sleep, libido and testosterone
• Why is my libido so low?

Frequently asked questions

Does Seroquel lower sex drive?
It can, though less often than many other antipsychotics. In a pooled analysis, quetiapine sat among the drugs with sexual dysfunction rates of 16% to 27%, against 40% to 60% for drugs such as risperidone and olanzapine. In a clinic survey of 636 people with schizophrenia, 18.2% on quetiapine reported sexual dysfunction. The illness plays a part too: studies of unmedicated psychosis found rates of 16.8% to 70%. Most of this data is observational, so it shows patterns and cannot pin the cause on the drug alone.

Does Seroquel raise prolactin?
Very little, in the trials that measured it. In a 6-week randomized trial, mean prolactin was 13.8 ng/mL on quetiapine against 57.7 on risperidone. In a 12-week double-blind trial, quetiapine had the lowest endpoint prolactin of three drugs. Low prolactin still leaves room for sexual side effects, though. In that same trial 50% on quetiapine still reported a sexual problem, and a 4-week study of 102 people found prolactin levels did not correlate with sexual dysfunction.

Will my sex drive come back if I stop Seroquel?
None of these studies tested stopping, so there is no number to give you, and stopping without your doctor risks the illness the medicine is holding back. What was tested is switching. The Cochrane review found no evidence of benefit from switching risperidone to quetiapine (95% CI -5.79 to 1.75), and of 2 randomized switch-to-quetiapine trials, 1 improved its main outcome and 1 did not. Any change belongs in a conversation with your prescriber, who can weigh it against everything else.

Is Seroquel better or worse than other antipsychotics for sex drive?
In pooled and survey data, fewer people on quetiapine reported sexual side effects than on risperidone, olanzapine or haloperidol. A randomized trial found 16% on quetiapine against 50% on risperidone, but it was open-label and small. The one double-blind trial found 50% on quetiapine against 42% on risperidone, with only 6 people taking quetiapine. The right drug for you depends on far more than this one side effect, so that choice sits with your prescriber.

Can I take a botanical supplement with Seroquel?
Ask your prescriber first, and bring the label. NUUD's label says to avoid use if you are on blood pressure medication, have cardiovascular, renal, or pulmonary conditions, or if you are sensitive to any of the ingredients. NUUD does nothing for bipolar disorder, schizophrenia, depression, anxiety, or the side effects of Seroquel or any antipsychotic, and it has no role in managing a medical condition. No interaction studies exist for this formula, so the decision is yours and your prescriber's.

References

1. Serretti A, Chiesa A. A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics. International clinical psychopharmacology. 2011;26(3):130-40. https://pubmed.ncbi.nlm.nih.gov/21191308/
2. Montejo AL, Majadas S, Rico-Villademoros F, Llorca G, De La Gándara J, Franco M, et al. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics. The journal of sexual medicine. 2010;7(10):3404-13. https://pubmed.ncbi.nlm.nih.gov/20214720/
3. Vargas-Cáceres S, Cera N, Nobre P, Ramos-Quiroga JA. The Impact of Psychosis on Sexual Functioning: A Systematic Review. The journal of sexual medicine. 2021;18(3):457-466. https://pubmed.ncbi.nlm.nih.gov/33504468/
4. Cañada Y, Navalon P, Zazula R, Dodd S, Berk M, García-Blanco A, et al. Sexual dysfunction in bipolar disorder: A systematic review. European neuropsychopharmacology. 2026;109:112827. https://pubmed.ncbi.nlm.nih.gov/41930708/
5. Young SL, Taylor M, Lawrie SM. "First do no harm." A systematic review of the prevalence and management of antipsychotic adverse effects. Journal of psychopharmacology. 2015;29(4):353-62. https://pubmed.ncbi.nlm.nih.gov/25516373/
6. Bobes J, García-Portilla MP, Rejas J, Hernández G, Garcia-Garcia M, Rico-Villademoros F, et al. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. Journal of sex & marital therapy. 2003;29(2):125-47. https://pubmed.ncbi.nlm.nih.gov/12623765/
7. Knegtering R, Castelein S, Bous H, Van Der Linde J, Bruggeman R, Kluiter H, et al. A randomized open-label study of the impact of quetiapine versus risperidone on sexual functioning. Journal of clinical psychopharmacology. 2004;24(1):56-61. https://pubmed.ncbi.nlm.nih.gov/14709948/
8. Kelly DL, Conley RR. A randomized double-blind 12-week study of quetiapine, risperidone or fluphenazine on sexual functioning in people with schizophrenia. Psychoneuroendocrinology. 2006;31(3):340-6. https://pubmed.ncbi.nlm.nih.gov/16198059/
9. Byerly MJ, Nakonezny PA, Bettcher BM, Carmody T, Fisher R, Rush AJ. Sexual dysfunction associated with second-generation antipsychotics in outpatients with schizophrenia or schizoaffective disorder: an empirical evaluation of olanzapine, risperidone, and quetiapine. Schizophrenia research. 2006;86(1-3):244-50. https://pubmed.ncbi.nlm.nih.gov/16730951/
10. Nagaraj AK, Pai NB, Rao S. A comparative study of sexual dysfunction involving risperidone, quetiapine, and olanzapine. Indian journal of psychiatry. 2009;51(4):265-71. https://pubmed.ncbi.nlm.nih.gov/20048451/
11. Bandelow B, Chouinard G, Bobes J, Ahokas A, Eggens I, Liu S, et al. Extended-release quetiapine fumarate (quetiapine XR): a once-daily monotherapy effective in generalized anxiety disorder. Data from a randomized, double-blind, placebo- and active-controlled study. The international journal of neuropsychopharmacology. 2010;13(3):305-20. https://pubmed.ncbi.nlm.nih.gov/19691907/
12. Clayton AH, Locklear JC, Svedsäter H, McIntyre RS. Sexual functioning in patients with major depressive disorder in randomized placebo-controlled studies of extended release quetiapine fumarate. CNS spectrums. 2014;19(2):182-96. https://pubmed.ncbi.nlm.nih.gov/24067192/
13. Clayton AH, Tsai J, Mao Y, Pikalov A, Loebel A. Effect of Lurasidone on Sexual Function in Major Depressive Disorder Patients With Subthreshold Hypomanic Symptoms (Mixed Features): Results From a Placebo-Controlled Trial. The Journal of clinical psychiatry. 2018;79(5):18m12132. https://pubmed.ncbi.nlm.nih.gov/30086213/
14. Westheide J, Cvetanovska G, Albrecht C, Bliesener N, Cooper-Mahkorn D, Creutz C, et al. Prolactin, subjective well-being and sexual dysfunction: an open label observational study comparing quetiapine with risperidone. The journal of sexual medicine. 2008;5(12):2816-26. https://pubmed.ncbi.nlm.nih.gov/18466271/
15. De Hert M, Detraux J, Peuskens J. Second-generation and newly approved antipsychotics, serum prolactin levels and sexual dysfunctions: a critical literature review. Expert opinion on drug safety. 2014;13(5):605-24. https://pubmed.ncbi.nlm.nih.gov/24697217/
16. McIntyre RS, Muzina DJ, Adams A, Lourenco MT, Law CW, Soczynska JK, et al. Quetiapine XR efficacy and tolerability as monotherapy and as adjunctive treatment to conventional antidepressants in the acute and maintenance treatment of major depressive disorder: a review of registration trials. Expert opinion on pharmacotherapy. 2009;10(18):3061-75. https://pubmed.ncbi.nlm.nih.gov/19954275/
17. Byerly MJ, Nakonezny PA, Rush AJ. Sexual functioning associated with quetiapine switch vs. risperidone continuation in outpatients with schizophrenia or schizoaffective disorder: a randomized double-blind pilot trial. Psychiatry research. 2008;159(1-2):115-20. https://pubmed.ncbi.nlm.nih.gov/18295343/
18. Schmidt HM, Hagen M, Kriston L, Soares-Weiser K, Maayan N, Berner MM. Management of sexual dysfunction due to antipsychotic drug therapy. The Cochrane database of systematic reviews. 2012;11(11):CD003546. https://pubmed.ncbi.nlm.nih.gov/23152218/
19. Nunes LV, Moreira HC, Razzouk D, Nunes SO, Mari Jde J. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review. Journal of sex & marital therapy. 2012;38(3):281-301. https://pubmed.ncbi.nlm.nih.gov/22533871/

This article is for general education and is not medical advice. Bipolar disorder, schizophrenia, depression and anxiety are medical conditions that only a licensed clinician can diagnose and manage, and Seroquel (quetiapine) is a prescription medicine. NUUD is a botanical supplement and has no role in diagnosing, treating, curing, or preventing bipolar disorder, schizophrenia, depression, anxiety, the side effects of any medication, or any other disease, and these statements have not been evaluated by the Food and Drug Administration. Talk with your doctor before starting any new supplement, and do not stop or change your medication without your doctor.