Dear Alice,

Can Ritalin, or similar medications, affect a male's ability to orgasm or ejaculate?

Dear Reader,

Sexual side effects associated with medications can certainly be frustrating, and while they aren't the most common reported issue for those taking methylphenidate (often known as Ritalin), it can impact some folks in this way. Methylphenidate is a medication used to treat attention deficit/hyperactivity disorder (ADHD) and goes by other brand names as well, including Concerta, Daytrana, Quillivant, Metadate, Methylin, and Aptensio. But, methylphenidate isn’t just for ADHD; it’s also used to treat narcolepsy, Parkinson's disease, and depression. Though these meds may hamper the bedroom vibe for some people because it may decrease sex drive, there could be other reasons for not experiencing the "big bang" — such as stress, a psychological condition, or other medications that are taken simultaneously. Some other drugs prescribed for mental health conditions — including selective serotonin reuptake inhibitors (or SSRIs) — have been shown to have sexual side effects, too. Therefore, there are a lot of possible reasons why someone may experience a hard time getting... um... hard.

To answer your question more specifically: do problems reaching orgasm or ejaculating make the list of side effects? Not exactly (if you, or someone you know is experiencing this, check out Endless endurance, but no orgasm in the Go Ask Alice! archives, which outlines the different reasons why this could be happening and potential the next steps). Rather, the documented sexual side effects from methylphenidate include decreased sex drive, frequent or painful erections, and priapism (when an erection is sustained for several hours). Priapism is quite a rare and serious side effect. If the condition is suspected, it requires immediate medical attention.  

While methylphenidate may impact some folks' sex lives more directly, some of the other possible side effects might be indirectly affecting a man's mojo. Common side effects include:

  • Nervousness
  • Irritability
  • Insomnia or restlessness
  • Nausea, vomiting, stomach pain, heartburn, or loss of appetite
  • Diarrhea
  • Headaches
  • Slowed growth
  • Dry mouth
  • Numbness or tingling in the hands or feet
  • Increased heart rate
  • Elevated blood pressure

List adapted from MedlinePlus.

Less often, people taking methylphenidate may experience chest pain, irregular heart rates, fainting, seizures, fevers, and hives or rashes (any of which would benefit from a consultation with a health care professional). Researchers are constantly learning more about the short- and long-term effects of medications, so stay tuned for even more news on whether libido or sexual performance may be affected. Additionally, while methylphenidate can treat a number of conditions guided by a health care provider, taking an amount other than the dose prescribed or using it when it hasn’t been specifically prescribed for you might increase the risk of adverse effects, including those affecting desire and sexual functioning.

In any case, there are a range of possible explanations for experiencing sexual difficulties both related to using this medication and sans pharmaceutical interference. As such, it’s good to know that a health care provider can be a great resource in figuring out the most beneficial and safest dose and combination of treatments to keep the libido as alive and kickin’ as possible.

Hope this helps rid you of some of your concerns!


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