Here is my experience. Paxil and Zoloft made it much more difficult and occasionally impossible to achieve orgasm. which other than the few times it was impossible is really kind of a benefit. However they didn't give me all th help I needed fro depression. So I was switched onto Effexor. This was a miracle drug compared to the others for the depression. Downside was the sexual side effects are much worse. Reduced libido and impaired erectile function. It also may increase BP which resulted in me needing medication for that. One of them had a side effect of.....impaired erectile function. Not good. Now I am on a dramatically reduced dosage of effexor with added wellbutrin. Libido is definitely coming back. erectile function seems to be improved. Downside at this point is that it seems to have made me uhmmmmm quick on the draw so to speak. Never had a problem with that before. Post holidays the ARNP that is managing my medications is gong to swith me to zoloft/wellbutrin. Hopefully that will get things more normal again.