Does Strattera Affect Sex Drive? What the Studies Actually Show

Strattera and sex drive: yes, there is an effect, and it has been counted in adult men. In the pooled placebo-controlled adult trials, adult men on Strattera (atomoxetine) reported lower desire at 4.6% against 3.0% on placebo, erection problems at 8.0% against 1.9%, and trouble finishing at 2.8% against 1.1%. Women and adolescent boys looked like placebo. The events started in weeks 2 and 3, and most resolved over 3 to 8 weeks. A network meta-analysis of ten adult ADHD trials found one desire difference among the drugs compared, and it was atomoxetine against placebo.

Figures from Camporeale et al. 2013 (PMID 23775507) and Adler et al. 2009 (PMID 19142107). Pooled manufacturer trials with open-ended questioning; the authors say the events were likely underreported.

Is it the Strattera, or is it me?

You typed a drug name into a search bar at midnight because your drive went flat a few weeks after you started taking it, and the internet handed you a wall of confident answers. That question has two halves, and both halves are real.

ADHD on its own goes with sexual difficulties. Puszcz and colleagues (2025) reviewed sexual functioning in adults with ADHD, built by six independent researchers searching for work available as of May 2024. They report that a substantial proportion of men and women with ADHD describe problems running in both directions, some more wanting and some less. They point to sensory differences, attention deficits, hyperfocus and a need for frequent change. On medication, they write that stimulants and non-stimulants both show helpful and harmful effects, and they call the empirical data limited.

This page goes one drug deep. We keep the ADHD and the atomoxetine apart wherever the studies let us, since most of these papers report rating scale scores and adverse events, and never measure desire with a questionnaire. For the diagnosis itself, read our page on ADHD and sex drive. For the stimulants, there is a page on Adderall and sex drive and one on Vyvanse and sex drive.

What the pooled trials counted

One paper sat down and counted. Camporeale and colleagues (2013) pooled every placebo-controlled atomoxetine trial in adults: 3,314 people, 1,738 on atomoxetine and 1,576 on placebo. They also pooled adolescents aged 13 to under 18 in placebo-controlled trials, 538 people.

In adult men, atomoxetine against placebo came out like this. Lower desire 4.6% against 3.0%. Erection problems 8.0% against 1.9%. Trouble finishing 2.8% against 1.1%. Painful urination 3.7% against 1.5%. Urinary hesitation 6.9% against 2.4%. Decreased urine flow 2.5% against 0.6%. In women and adolescent boys, the sexual and urinary event profiles looked clinically similar to placebo. Most events were not severe, and discontinuations ran numerically higher on atomoxetine. The trials all came from one manufacturer, and the events were gathered by open-ended questioning, which means the person had to bring it up. The authors write that these events were likely underreported.

The registration trials behind that pool are Michelson and colleagues (2003): two identical 10-week double-blind placebo-controlled trials with 280 and 256 adults. Atomoxetine was statistically superior to placebo on inattentive and hyperactive-impulsive scores, and discontinuation for adverse events stayed under 10% in both. That abstract carries no sexual outcome at all, so here it carries its sample sizes.

Simpson and colleagues (2004) summarize the same two trials at 60, 90 or 120 milligrams a day. Withdrawal for adverse events ran 7.8% against 4.3% in one trial and 9.3% against 2.4% in the other, significant in the second. Their list of events reported significantly more often with atomoxetine includes sexual problems, sitting next to dry mouth, insomnia, nausea, decreased appetite, constipation, dizziness, sweating, painful urination and palpitations. Both reviews give counts for the withdrawals, and no count for the sexual events.

Where the desire signal sits among the ADHD drugs

Chierrito de Oliveira and colleagues (2019) ran a pairwise and network meta-analysis of 10 randomized double-blind trials in adults, 3,006 people, comparing the ADHD drugs against each other and against placebo. Four areas produced statistically significant differences: decreased appetite, insomnia, sleepiness and desire.

Decreased appetite came out for atomoxetine against placebo (OR 0.15, 95% credibility interval 0.05 to 0.38) and for extended-release mixed amphetamine salts against placebo (0.06, 0.00 to 0.51). Insomnia came out for atomoxetine against placebo (0.48, 0.27 to 0.88) and for the salts against placebo (0.23, 0.06 to 0.76). Sleepiness came out for atomoxetine against methylphenidate OROS (0.24, 0.06 to 0.97).

The desire line is the one you came for, and it is the only sexual outcome in that abstract: decreased libido, atomoxetine against placebo, OR 0.28, 95% credibility interval 0.08 to 0.90. It is the only desire difference among the ADHD drugs compared. The abstract prints an odds ratio and a credibility interval, and gives no per-drug event counts, no doses, no follow-up length and no note on whether desire came from a questionnaire. We print it the same way, and we will not guess which direction it runs. Our Vyvanse page charts that network ranking, so the number stays in words here.

Cortese and colleagues (2018) cover 133 double-blind randomized trials, 51 of them in adults. In adults rated by clinicians, atomoxetine beat placebo (SMD -0.45, 95% CI -0.58 to -0.32), and it was worse than placebo on dropping out for side effects (OR 2.33, 95% CI 1.28 to 4.25). Confidence ran from high or moderate for some comparisons down to low or very low for most indirect ones. No sexual figure appears in that abstract, and tolerability there means dropout.

For scale, one number from a stimulant cohort. Edvinsson and colleagues (2018) followed Swedish adults with ADHD for 6 years; 112 were available at follow-up, and 57 were still on methylphenidate. Among those, 17% reported decreased sexual desire. That figure belongs to a stimulant cohort, and it sits here to show the neighbourhood these numbers live in.

When it starts and when it fades

Camporeale and colleagues (2013) put dates on the events. Urinary events showed up inside the first 2 weeks. Erection problems and trouble finishing showed up in weeks 2 and 3. Median resolution ran about 3 to 8 weeks after onset, depending on the event. That is an early start with a slow fade, which matches how people describe it: a change noticed in the first month, then a long tail.

Upadhyaya and colleagues (2015) ran a longer study: 12 weeks open-label at 40 to 100 milligrams a day, then 12 weeks of double-blind maintenance at 80 or 100 milligrams, then people who responded were randomized to atomoxetine (266) or placebo (258) for a 25-week withdrawal. Common events appeared within week 1. Some resolved quickly. Others ran a longer course, male sexual side effects among them, with median resolution times of 3 to 53 days.

Blood pressure and heart rate increases during the run returned to baseline after the drug stopped. The run-in was open-label, so those early events have no placebo comparison, and the 3 to 53 day range covers every event measured.

Durell and colleagues (2010) split two double-blind trials by age: adults aged 18 to 25 (mean 21.7 years) against adults over 25 (mean 43.4 years). Atomoxetine helped in both groups. Response ran 56.4% in the younger group and 47.8% in the older one (p = .188). Tolerability looked similar between the age groups, with one stated difference: older adults reported more sexual side effects. The abstract states that without attaching a number.

Wietecha and colleagues (2013) pooled open-ended event data from 22 pediatric and 3 adult trials. In adults the most common events were nausea, insomnia, decreased appetite, urinary hesitation or retention, and fatigue. Adult erection data were excluded from that list on purpose. A pooled list built that way cannot be read as reassurance.

The rare reports, in proportion

Five reports sit outside the pools. Yaylaci and colleagues (2020) describe a 16-year-old with ADHD who had spontaneous release beginning on the third day of atomoxetine, and it ended when the drug was stopped. The authors note that sexual side effects are reported in adults while knowledge in children and adolescents stays limited. It is one adolescent, with no control group and no stated dose.

McGrane and colleagues (2021) describe a 42-year-old man taking atomoxetine 40 milligrams a day. Urinary hesitancy with a milky white discharge began within 2 days of starting. Blood tests, urinalysis, sexually transmitted infection testing and physical examination were unremarkable. The events cleared within 2 days of stopping. The authors scored causality on the Naranjo scale at 5, which reads as probable. Their review notes that urine outflow events occur more often in men than women and resolve quickly on stopping, and that spontaneous release and sexual side effects rarely occur with atomoxetine. Their practical point is that clinicians should ask directly, because people may not report these.

Narahari and colleagues (2026) describe a man in his late 20s who had taken aripiprazole 7.5 milligrams daily for 6 months. Five days after starting atomoxetine he developed sudden pain in both testicles, then a painful erection lasting more than 4 hours. It settled about 6 hours after onset with no invasive procedure, the drug stopped the next day, and nothing recurred at 4-week follow-up. Naranjo scored 4, read as possible causality, and he was on two drugs at once. Rizvi and colleagues (2022) published an adult case report of spontaneous release linked to atomoxetine; the abstract carries the title, the authors and the journal line, with no case narrative.

Carpenter and colleagues (2005) point the other way. Atomoxetine was added to antidepressants in 15 adults with a depressive disorder who had partially responded or not responded to at least 8 weeks of standard antidepressant medication. The mean endpoint dose was about 80 milligrams a day, and 6 of 15 reported improved sexual function. That group had depression, took antidepressants and ran with no placebo arm.

Set those five reports against 1,738 adults on atomoxetine in the pooled trials. A case report tells you an event is possible. It says nothing about how often it happens. If your own labs came back normal and you still feel flat, our page on numbers fine, still flat covers that gap.

What has been counted, in order

Strattera (atomoxetine) is a non-stimulant ADHD medication, and it is the one ADHD drug with pooled placebo-controlled counts for sexual side effects. Six published looks have tried to size the effect. Two registration trials reported no sexual count at all. A six-month trial counted erection problems. A pooled analysis of every adult placebo-controlled trial put names and percentages on desire, erection, finishing and urinary events in men. A network analysis found one desire difference among ADHD drugs. None of them asked the question the same way, so read each number as its author's.

Atomoxetine in the studies: what each measured, and whose number it is.

Study	Design	Who	Finding	Whose number
Camporeale 2013	Pooled analysis of all adult placebo-controlled trials	3,314 adults (1,738 atomoxetine, 1,576 placebo)	Adult men: desire 4.6% against 3.0%, erection problems 8.0% against 1.9%, trouble finishing 2.8% against 1.1%. Women and adolescent boys like placebo	Adult men's, and likely underreported
Adler 2009	6-month randomized double-blind trial	501 adults (250 atomoxetine, 251 placebo)	Erection problems and urinary hesitation significantly more often; 17.2% against 5.6% stopped for side effects	The trial's, with no rate printed for the erection figure
Chierrito de Oliveira 2019	Pairwise and network meta-analysis of 10 randomized double-blind trials	3,006 adults	Decreased libido, atomoxetine against placebo: OR 0.28 (95% credibility interval 0.08 to 0.90), the only sexual outcome difference among the drugs compared	The class comparison's
Durell 2010	Post hoc split of two trials by age	Adults aged 18 to 25 against adults over 25	Older adults reported more sexual side effects; tolerability otherwise similar between the age groups	Stated without a number
Edvinsson 2018	6-year prospective naturalistic cohort	112 adults on medication at follow-up, 57 still on methylphenidate	Decreased sexual desire in 17% of the people still on methylphenidate	A stimulant's number. Strattera has no matching count
McGrane 2021	Single case report	A 42-year-old man taking 40 milligrams a day	Urinary hesitancy with a milky white discharge within 2 days of the first dose, gone within 2 days of stopping; causality score 5, read as probable	One person's

What actually helps, graded honestly

Nothing has been tested as a fix for atomoxetine's sexual side effects. No trial in this record randomized people to a treatment for these events. The narrative review of sexual functioning in adults with ADHD says it plainly: the empirical data on medication effects are limited, and stimulant and non-stimulant effects run in both directions. So everything below is graded by what it is, and none of it is a study of this problem.

Time carries the most weight, and it comes straight from the counts. In the pooled analysis of 3,314 adults, erection and finishing events began in weeks 2 and 3, and median resolution ran about 3 to 8 weeks after onset with the drug continued. The withdrawal study found common events appearing in week 1 and median resolution times of 3 to 53 days across events. That is a real pattern sitting on a wide range.

Stopping is the other observed outcome. In the case reports, symptoms were gone within 2 days of stopping atomoxetine, and an adolescent's event ended when the drug was stopped. Those are single people with no control arm. Stopping is your prescriber's decision, and the medication is doing work on your attention that you cannot feel day to day.

The dose is a question. The dosing analyses here compared once daily with twice daily, and fast titration with slow, for appetite, sleepiness, nausea and abdominal pain. None of them reported sexual events against dose. Ask about dose. Do not assume anyone has an answer on file.

Asking directly matters more than anything else on this page. The pooled trials collected these events by open-ended questioning, and the authors wrote that they were likely underreported. The case report authors put it as advice to clinicians: ask, because people may not bring them up. If you want to read around the feeling first, our pages on brain fog and sex drive, low libido in men and low libido in women cover the ground around it.

Does it wear off on its own?

In the counted data, usually yes, and often with the drug continued. Median resolution ran about 3 to 8 weeks after onset depending on the event in the pooled analysis of 3,314 adults. The withdrawal study put median resolution at 3 to 53 days across all events, with the men's sexual side effects among the slower to clear. In the case reports, symptoms were gone within 2 days of stopping, and the adolescent's event ended when atomoxetine stopped. One gap matters: no trial measured desire after people stopped atomoxetine, so nobody has a number for the months after. Counted events usually fade. Do not stop on your own, and tell your prescriber what is happening.

What to bring to your prescriber

This conversation goes better when you arrive with specifics, and these details change what your prescriber can do. Write them down before you go in. Six things, in an order that works.

1. The timeline. The counted events start in weeks 2 and 3 for erection problems and trouble finishing, and within the first 2 weeks for urinary events. Say which week yours started in.
2. Which event it is. Desire, erection problems and trouble finishing carry different rates in adult men: 4.6% against 3.0%, 8.0% against 1.9%, and 2.8% against 1.1%. Naming the event names the number that applies to you.
3. Ask to be asked. The trials counted only what people volunteered under open-ended questioning, and the authors say these events were likely underreported. Say the thing you would not say if nobody asked.
4. The ADHD underneath. Reviews report sexual problems in adults with ADHD in both directions, more desire and less, shaped by attention, hyperfocus and sensory differences. Your baseline changes how your prescriber reads the change.
5. The other medicines in the mix. One case report involved atomoxetine added to aripiprazole, and its causality score landed at possible because two drugs were on board at once. Bring the whole list.
6. The supplement question, bottle in hand. Put the actual bottle on the desk and read the label caution out loud, together.

The everyday levers, and where a botanical fits

Start with who this section is not for. Blood pressure medication, heart conditions, kidney disease and lung conditions are all common in the population reading this page, and they are exactly what NUUD's own label warns about: 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. For some readers that sentence is the whole answer. Bring the bottle to your prescriber before you bring it home.

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

• Your ADHD care, first. Untreated ADHD comes with sexual problems of its own in reviews, in both directions, so getting the diagnosis and the medication plan right is the biggest lever on this list, and it belongs to your prescriber.
• Sleep, in amount and in quality. Dosing studies show insomnia and sleepiness shifting with dose timing and titration speed, and broken sleep lands on desire directly. Sleep, libido and testosterone covers that.
• Movement you can keep up, on the days your attention allows it. Exercise and libido covers the wider picture.
• Time and safety, with a partner or on your own, with nothing expected at the end. A relationship running on logistics and zero unscheduled hours is its own reason for flat wanting.
• 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 ADHD, for attention, or for the side effects of atomoxetine or any medication, 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, on a timeline of 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 men's libido gummies are for. There is a women's version.

Nothing is wrong with you

Two useless answers are out there, and you have heard both. One is the shrug: everyone has a flat month, it is on the label, get on with it. The other is the forum certainty that Strattera ends your sex drive for good, posted by someone who has never read your chart. The counted data sit in a duller middle. In adult men across 3,314 people in pooled placebo-controlled trials, lower desire showed up in 4.6% on atomoxetine against 3.0% on placebo, and erection problems in 8.0% against 1.9%. Most events were not severe, and most faded over weeks. Women and adolescent boys looked like placebo in the same analysis.

Then look at everything else in the room. ADHD itself goes with sexual difficulties in reviews, in both directions. So does a hard year: sleep debt, money, a mood nobody has treated, a relationship running on logistics. Wanting has more than one input. If you are lying awake doing arithmetic about a medication that is holding your attention together, that is a hard problem, and hard problems deserve a real conversation. The goal is wanting to want it again. The goal is feeling normal again.

Keep reading

• ADHD and sex drive
• Adderall and sex drive
• Does Vyvanse affect sex drive?
• Brain fog and sex drive
• Low libido in men
• Why is my libido so low?

Frequently asked questions

Does Strattera lower sex drive?
In adult men, by a small margin, yes. A pooled analysis of every adult placebo-controlled atomoxetine trial, 3,314 people, put lower desire at 4.6% on atomoxetine against 3.0% on placebo, and women and adolescent boys looked like placebo. A separate network analysis of 10 adult trials covering 3,006 people found one desire difference among the ADHD drugs compared, and it was atomoxetine against placebo. The pooled authors warn these events were likely underreported, so read both figures as a floor.

Does Strattera cause erection problems?
More often than placebo, in adult men, in the counted data. The pooled analysis put erection problems at 8.0% on atomoxetine against 1.9% on placebo, starting in weeks 2 and 3, with median resolution about 3 to 8 weeks after onset. A 6-month randomized trial found erection problems significantly more often on atomoxetine, alongside urinary hesitation, and printed no rate for that figure. Both counts came from adverse events collected by open-ended questioning.

Do the sexual side effects of Strattera go away?
In the counted trials they usually fade, and often while the drug continues. Median resolution ran about 3 to 8 weeks after onset in the pooled analysis, and 3 to 53 days across events in a withdrawal study where the men's sexual side effects were among the slower to clear. In two case reports the symptoms ended within days of stopping atomoxetine. No trial measured desire after people stopped the drug, so nobody has a number for life after it.

Is Strattera worse than Adderall or Vyvanse for sex drive?
No head-to-head count of sexual effects exists for these drugs, so nobody can rank them on desire. In the network analysis of 10 adult trials, the one desire difference was atomoxetine against placebo (OR 0.28, 95% credibility interval 0.08 to 0.90), and none appeared for the amphetamines. A 6-year cohort found decreased sexual desire in 17% of adults still on methylphenidate, a stimulant. The review evidence says medication effects run both ways, and calls the data limited.

Can I take a botanical supplement with Strattera?
Ask your prescriber first, with the bottle in hand. The NUUD label caution reads: 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. No interaction studies exist for this formula and atomoxetine. NUUD is a botanical supplement built around desire in general, and it does nothing for ADHD, for attention, or for the side effects of atomoxetine.

References

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2. Rizvi A, Srinivas S, Jain S. Spontaneous Ejaculation Associated With Atomoxetine. The primary care companion for CNS disorders. 2022;24(3):. https://pubmed.ncbi.nlm.nih.gov/35621830/
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7. Yaylacı F, Şahbudak B, Küçük Ö. Spontaneous Ejaculation Induced with Atomoxetine. Psychopharmacology bulletin. 2020;50(1):40-43. https://pubmed.ncbi.nlm.nih.gov/32214521/
8. McGrane IR, Campbell TJ. Probable Genitourinary Adverse Events Associated With Atomoxetine in an Adult Male: A Case Report. Journal of pharmacy practice. 2021;34(6):962-965. https://pubmed.ncbi.nlm.nih.gov/32862763/
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14. Narahari A, Kothari K. Atomoxetine-Associated Bilateral Testicular Pain and Priapism in a Patient Taking Aripiprazole: A Case Report. Case reports in psychiatry. 2026;2026:6645625. https://pubmed.ncbi.nlm.nih.gov/42491444/
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17. Upadhyaya H, Tanaka Y, Lipsius S, et al. Time-to-onset and -resolution of adverse events before/after atomoxetine discontinuation in adult patients with ADHD. Postgraduate medicine. 2015;127(7):677-85. https://pubmed.ncbi.nlm.nih.gov/26329980/
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This article is for general education and is not medical advice. ADHD is a medical condition that only a licensed clinician can diagnose and manage, and Strattera (atomoxetine) is a prescription medicine that should only be changed with your prescriber. NUUD is a botanical supplement and has no role in diagnosing, treating, curing, or preventing ADHD, 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.