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Serotonin affects sexual function through multiple mechanisms: Desire: Increased serotonin can reduce libido by suppressing dopamine signaling in reward circuits Arousal: Serotonin can reduce genital sensitivity and interfere with the physical arousal response Orgasm: Serotonin inhibits the spinal reflexes involved in orgasm, which is why delayed or absent orgasm is particularly common Nitric oxide: SSRIs may reduce nitric oxide availability, which is essential for genital blood flow in both men and women The persistence of sexual side effects relates to the fact that serotonins inhibition of sexual function does not typically adapt in the same way that GI effects do

Talk to your clinician about whether a dose increase is actually necessary before making the jump

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Additives like B12 do not meet FDA standards for a legitimate clinical difference and could increase health risks