Private-pay care · Virginia and Florida telehealth
Sexual side effects of antidepressants and other psychiatric medication are treatable.
Low desire, trouble with arousal or erections, and difficulty reaching orgasm are among the most common reasons people quietly stop a medication that was working. They are also among the most fixable, once someone takes them seriously as a clinical problem.
Every visit is by video with Sonia Mia Diaz, MD. Private patients are seen out of network, paid per visit, with a superbill.
Who this is for
Adults in Virginia or Florida whose sexual function changed after starting an antidepressant, antipsychotic, mood stabilizer or other psychiatric medication, and adults whose sexual symptoms track with depression, anxiety, trauma or stress. Sexual symptoms are often a diagnostic clue that a regimen is not yet optimized, not a side concern.
Low desire
Loss of interest despite emotional attachment, or a flattened sense of reward and motivation that arrived with the prescription.
Arousal and erectile difficulty
Including performance anxiety that has turned a transient problem into a persistent one.
Delayed or absent orgasm
A common effect of serotonergic medication, and one of the most responsive to a change in dose, timing or agent.
Changes with age and hormones
Perimenopausal decline, low testosterone and other hormonal contributors that overlap with mood and medication effects.
What the evaluation looks at
Your first visit is a 60-minute psychiatric evaluation by video with Dr. Diaz. For sexual side effects it covers:
- A medication review: which antidepressants, mood stabilizers, antipsychotics or other agents may be suppressing desire, impairing orgasm or blunting reward, and when the change began relative to each prescription.
- Whether depression, anxiety, trauma or stress physiology is driving the symptom rather than the medication.
- A medical and hormonal review to rule out anything confounding, with targeted labs when indicated, ordered through Fullscript and billed by the lab.
You leave with a plan, and every patient gets a written visit summary after each visit.
The opposite problem: new or increased sexual urges on medication
Less common, but important. Some medications raise sexual drive or trigger urges that feel out of character or hard to control. Aripiprazole (Abilify), brexpiprazole (Rexulti) and the dopamine agonists used for restless legs carry warnings for impulse-control problems that can include compulsive sexual behavior. Testosterone and some stimulants can push drive up as well. A sudden jump in sexual energy after starting or increasing an antidepressant can also be an early sign of hypomania, which changes the diagnosis and the plan. Dr. Diaz screens for these patterns because the answer is usually a medication change, not willpower. If this is happening, say so at the evaluation. It is a side effect, not a character flaw.
How Dr. Diaz approaches it
Every step is a clinical decision made at a visit and documented with its indication. Nothing is prescribed on request alone, and treatment happens within an established care relationship.
Correcting the regimen
In many patients the most effective step is not another prescription. It is adjusting the medication, dose or timing causing the dysfunction, or switching to an agent with a lower sexual side-effect burden, while protecting the psychiatric response.
A medical and hormonal review
Sexual symptoms have more than one possible cause, and the medication is not always the whole story. Dr. Diaz reviews thyroid function, sex hormones and other labs when the presentation suggests them, along with other prescriptions you take, blood pressure and blood sugar, sleep, alcohol and cannabis use, and relationship factors, so that nothing confounding is treated as a medication side effect by mistake.
Medications considered when appropriate
When the evaluation supports it, medications that address the specific symptom are considered alongside the psychiatric plan, chosen for your history and overall health. Prescriptions go to the pharmacy and are paid by you directly; Welmivia does not sell or dispense medication.
Follow-up that tracks the change
Response and side effects are reviewed against your baseline at standard follow-up visits, so adjustments are made on evidence rather than guesswork.
What it costs
Private patients pay per visit and are seen out of network, with a superbill after each visit; your plan decides any reimbursement. No membership is required.
Initial evaluation, 60 minutes by video
Medication follow-up, 15 minutes by video
Follow-up with psychotherapy, 30 minutes by video
Labs are billed by the lab. Medications are billed by the pharmacy. You receive a Good Faith Estimate when you schedule. See all fees.
Scope
Included: sexual side effects of psychiatric medication, low desire, erectile and arousal difficulty, orgasmic dysfunction, female sexual dysfunction, hormonal contributors, performance anxiety, and patients transferring care who need an independent reassessment. Not included: STI care, fertility treatment, pelvic pain disorders, procedural urology or gynecology, and enhancement requests without a clinical indication.
Transferring from another prescriber: bring your full prior treatment history. Continuation is not automatic; Dr. Diaz reassesses whether the current treatment still makes clinical sense once mood, anxiety, trauma, hormone status and medication burden are reviewed.
Questions patients ask
Will I have to stop my antidepressant?
Often not. Dose, timing, a switch within the same class, or an added agent can resolve the side effect while keeping the benefit.
Can you just prescribe something for it?
Not on request alone. Medications are considered when the evaluation supports them, after a review of your heart and metabolic health and the rest of your regimen.
Is this a men's health or women's health clinic?
No. It is psychiatric care that takes sexual function seriously in both men and women, because sexual symptoms are frequently part of the psychiatric picture.
Could it be something other than the medication?
Yes, and that is why the evaluation includes a medical and hormonal review. Thyroid problems, hormonal changes, other prescriptions, sleep, alcohol and relationship strain can all produce the same symptoms, and each is handled differently.
Can psychiatric medication increase sex drive or cause compulsive sexual behavior?
Yes. It is less common than low desire, but aripiprazole, brexpiprazole, dopamine agonists and testosterone can all do it, and new hypersexuality on an antidepressant can signal hypomania. Both need a prompt medication review, which is part of this evaluation.
Does Medicare cover this?
Welmivia Access patients can raise sexual side effects at any visit; it is part of standard medication management. Specific drug coverage is a Part D question for your plan.
Ready to take the side effect seriously?
Book an initial evaluation online, or call 434-623-0003 for a short call to check fit and coverage.
Welmivia Medical, PLLC · Sonia Mia Diaz, MD · Virginia and Florida telehealth · Private pay, per visit, with a superbill · This page is for informational purposes only and does not constitute medical advice. Treatment requires a clinical evaluation. Not a crisis service. In an emergency, call 911 or 988.
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