Antidepressants in teens: sexual side effects

The UK leaflets for fluoxetine and sertraline, two SSRI antidepressants prescribed to under-18s, list sexual side effects. Both warn that these problems have sometimes continued after stopping, which is called post-SSRI sexual dysfunction, or PSSD.

That warning is in the pack your child brings home. Two researchers wrote in 2015 that the large trials in under-18s didn’t routinely ask about sexual side effects.

Jevin was 11 when a psychiatrist prescribed him Zoloft, a brand of sertraline. At 10, he says, he’d been up late into the night crying, and counselling hadn’t got far. He was 26 when Moral Medicine interviewed him in 2024.

Play video: Jevin, first prescribed an antidepressant at 11 (extract)

He took antidepressants on and off until he was about 25, and only then heard of PSSD. He knew the label listed sexual side effects. Even so, he says, “some of it I thought was just me or just my personality or just a quirk about me”.

Do antidepressants cause sexual side effects in teenagers?

The leaflets list them, and each adds a paragraph for under-18s. The fluoxetine leaflet puts “decreased sex drive or sexual problems” among its common side effects. For ages 8 to 18 it goes on: “In addition to the possible side effects listed above, Fluoxetine may slow growth or possibly delay sexual maturity”.

The sertraline leaflet lists “decreased sexual interest” as common, among side effects “seen in clinical trials in adults and after marketing”. For under-18s it adds: “In clinical trials with children and adolescents, the side effects were generally similar to adults”. It also reports a three-year study in which children on sertraline “developed normally other than mild weight gain in those treated with a higher dose”.

Each leaflet speaks for its own medicine and its own studies. Neither compares the two.

The longer version of the fluoxetine leaflet, written for prescribers, says: “Isolated cases of adverse events potentially indicating delayed sexual maturation or sexual dysfunction have been reported from paediatric clinical use”.

How often? No reliable figure exists. The two researchers, in child psychiatry, wrote that the trials “did not routinely evaluate sexual symptoms and side effects”.

These are UK leaflets as of October 2026. The fluoxetine one is a single company’s, last revised in September 2022. Yours may come from another company or another country, so check the leaflet in your own pack.

Can antidepressant sexual side effects last after stopping?

The leaflets say they can. Both carry the same sentence, and it names no age.

“In some cases, these symptoms have continued after stopping treatment.”

For some people PSSD has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.

The one study that tried to count PSSD used the health records of men aged 21 to 49.

In December 2025 the UK medicines regulator, the MHRA, said its expert advisers had recommended updating some antidepressant leaflets on “sexual dysfunction that may continue after stopping treatment”.

Jevin had been off his tablets for a little over a year when he was interviewed. Asked if he’d seen improvements, he says “not really”. What keeps him going, he says, is believing he can get better.

What should parents watch for on an SSRI?

Mood and behaviour. That is the fluoxetine leaflet’s own warning for this age: “Patients under 18 have an increased risk of side-effects such as suicide attempt, suicidal thoughts and hostility (predominantly aggression, oppositional behaviour and anger) when they take this class of medicines”.

It tells anyone who has thoughts of harming themselves to “contact your doctor or go to a hospital straight away”. The NHS says to call 111, or 999 if someone is in danger. In the UK and Ireland the Samaritans are on 116 123, free, at any hour.

The leaflet suggests asking a relative or close friend to read it. NICE guidance for England asks for close contact with the young person and their parents early on.

Growth and puberty are for the doctor to check. The prescribers’ version says growth and “pubertal development” should be monitored “during and after treatment with fluoxetine”. Sertraline’s tells doctors to monitor “growth and development”.

Fluoxetine for a teenager, seen from home

Before the first dose

Side effects are explainedTo your child and to you, with written information.

The first weeks

Close contact with the prescriberAt home, you watch mood and behaviour.

During treatment

Growth and puberty are monitoredThe prescriber does this.

After the last dose

Growth and puberty checks go onSeparately, the leaflet says sexual side effects have sometimes continued.

What can I do?

These medicines help many young people, and a prescriber weighs that against the risks for each child. Whether your child takes one, and what to do about a side effect: that’s a decision for you, your child and the prescriber. The fluoxetine leaflet says: “Do not stop taking Fluoxetine without asking your doctor first”.

You don’t have to ask your teenager about sex. Asking about side effects is the prescriber’s job, and you can ask them to cover every side effect in the leaflet at a review.

At home, an open door is enough. Let your child know the leaflet lists side effects like these, and that they can tell you, the GP or the mental health team at any time.

Who do you tell? During treatment, the prescriber, often a child and adolescent mental health team (CAMHS). Afterwards, your child’s GP. Bring the leaflet, open at the sentence about symptoms continuing after stopping.

Write down the dates and what you notice: “Fluoxetine 10 mg a day from 3 March 2026. Quieter and flatter since April”.

For parents, YoungMinds runs a free, confidential Parents Helpline.

You can report a suspected side effect yourself: the Yellow Card scheme takes reports from “patients, parents, and carers”, for yourself or for someone else “with their permission”. Our guide to reporting PSSD on the Yellow Card shows the form.

Play video: Yellow Card - How to report

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208).

Our reporting guide walks you through it

What else do people ask?

Is it the same for fluoxetine and sertraline? The sentence about symptoms continuing after stopping is the same. In the UK, fluoxetine is licensed for depression from the age of 8, and sertraline, under 18, for obsessive compulsive disorder. Each has its own article: Prozac and sertraline.

What does the NHS say? Its antidepressants page says that for some people, problems with sex “may carry on after stopping antidepressants”. We look at the page in NHS on antidepressant sexual side effects.

What does PSSD feel like? Adults describe it in their own words in What does PSSD feel like? and in PSSD in women. Our page on PSSD has the rest.

Jevin had support through his teens. “My mom was there the whole time,” he says. “She was a lifeline for me.”

Sources

1. Fluoxetine 20 mg hard capsules, patient leaflet (UK), one company’s leaflet (Brown & Burk UK Ltd), Electronic Medicines Compendium (EMC 15755), last revised September 2022, read 12 October 2026. Section 1: for children and adolescents aged 8 and above, moderate to severe major depressive disorder, “only in combination with psychological therapy”. Section 2 has the heading “Thoughts of suicide and worsening of your depression or anxiety disorder”. It says: “If you have thoughts of harming or killing yourself at any time, contact your doctor or go to a hospital straight away”. It adds: “You may find it helpful to tell a relative or close friend that you are depressed or have an anxiety disorder, and ask them to read this leaflet”. Section 2, “Children and adolescents (aged 8 to 18 years)”, has the sentence we quote in full. It goes on: “Fluoxetine should only be used in children and adolescents aged 8 to 18 years for the treatment of moderate to severe major depressive episodes (in combination with psychological therapy) and it should not be used to treat other conditions”. Then: “only limited information concerning the long-term safety of fluoxetine on growth, puberty, mental, emotional and behavioural development in this age group is available”. A doctor may still prescribe it to a patient under 18 “because he/she decides that this is in your best interests”. The leaflet adds: “If your doctor has prescribed Fluoxetine for a patient under 18 and you want to discuss this, please go back to your doctor”. And: “You should inform your doctor if any of the symptoms listed above develop or worsen when patients under 18 are taking Fluoxetine”. The section ends: “Fluoxetine should not be used in the treatment of children under the age of 8 years”. Section 2, “Sexual dysfunction”: “Medicines like Fluoxetine (so called SSRIs) may cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have continued after stopping treatment”. That paragraph names no age. Section 3, for ages 8 to 18: “Treatment should be started and be supervised by a specialist”, with a starting dose of 10 mg a day; for everyone, “Do not stop taking Fluoxetine without asking your doctor first”. Section 4: “decreased sex drive or sexual problems (including difficulty maintaining an erection for sexual activity)” is listed as common, and “sexual problems, including orgasm problems, occasionally persisting after treatment discontinuation” as uncommon. The paragraph for ages 8 to 18, in full: “In addition to the possible side effects listed above, Fluoxetine may slow growth or possibly delay sexual maturity. Suicide-related behaviours (suicide attempt and suicidal thoughts), hostility, mania, and nose bleeds were also commonly reported in children.”
2. Fluoxetine 20 mg hard capsules, summary of product characteristics (UK, the version for prescribers), text revised 28 September 2022, read 12 October 2026. Section 4.4, “Sexual dysfunction”: “There have been reports of long-lasting sexual dysfunction where the symptoms have continued despite discontinuation of SSRIs”. The same section says of under-18s: “only limited evidence is available concerning long-term effect on safety in children and adolescents, including effects on growth, sexual maturation and cognitive, emotional and behavioural developments”. It goes on: “The possibility of a delay in puberty cannot be ruled out”. Then: “Growth and pubertal development (height, weight and TANNER staging) should therefore be monitored during and after treatment with fluoxetine. If either is slowed, referral to a paediatrician should be considered”. Section 4.8 says its table gives the adverse reactions “in adult and paediatric populations”. Under “Paediatric population” it says: “Adverse reactions that have been observed specifically or with a different frequency in this population are described below”. One of them: “Isolated cases of adverse events potentially indicating delayed sexual maturation or sexual dysfunction have been reported from paediatric clinical use”. Section 5.3 describes studies in young animals and says “The significance of these findings in humans is unknown”.
3. Lustral (sertraline) 50 mg and 100 mg film-coated tablets, patient leaflet (UK), Electronic Medicines Compendium (EMC 2835), last revised December 2025, read 12 October 2026. Section 2, “Sexual problems”: “Medicines like Lustral (so called SSRIs) may cause symptoms of sexual dysfunction (see section 4). In some cases, these symptoms have continued after stopping treatment”. That paragraph names no age. Section 2, “Children and adolescents”, opens: “Sertraline should not usually be used in children and adolescents less than 18 years old, except for patients with Obsessive Compulsive Disorder (OCD)”. The leaflet gives that use as ages 6 to 17. It goes on: “Patients under 18 have an increased risk of undesirable effects, such as suicide attempt, thoughts of harming or killing themselves (suicidal thoughts) and hostility”. Then: “it is possible that your doctor decides to prescribe Lustral to a patient under 18 if it is in the patient’s interest”. And: “If your doctor has prescribed Lustral to you and you are less than 18 years old and you want to discuss this, please contact him/her”. It reports a three-year study of “growth, maturation and learning (cognitive) and behavioural development” in “more than 900 children aged 6 to 16 years”. The result: “children treated with sertraline developed normally other than mild weight gain in those treated with a higher dose”. Section 4: “The following side effects were seen in clinical trials in adults and after marketing”. Among them are “ejaculation failure” (very common), “decreased sexual interest” and “erectile dysfunction” (common), and “sexual dysfunction” and “female sexual dysfunction” (uncommon). Then, under “Additional side effects in children and adolescents”: “In clinical trials with children and adolescents, the side effects were generally similar to adults (see above). The most common side effects in children and adolescents were headache, insomnia, diarrhoea and feeling sick”. The version for prescribers, revised December 2025, says in section 4.4 that “A few cases of retarded growth and delayed puberty have been reported post-marketing. The clinical relevance and causality are yet unclear”, and that doctors “must monitor paediatric patients on long term treatment for abnormalities in growth and development”. Its section 4.8: “In over 600 paediatric patients treated with sertraline, the overall profile of adverse reactions was generally similar to that seen in adult studies.”
4. NICE, Depression in children and young people: identification and management, guideline NG134, published 25 June 2019, read 12 October 2026. The young person “(and their parents or carers, as appropriate) should be informed about the rationale for the drug treatment, the delay in onset of effect, the time course of treatment, the possible side effects”, with written information. “Specific arrangements must be made for careful monitoring of adverse drug reactions”, for example “weekly contact with the child or young person and their parents or carers for the first 4 weeks of treatment”. The guideline does not mention sexual side effects.
5. MHRA, Patient and family experiences inform antidepressant safety information review, 1 December 2025. The Commission on Human Medicines advised strengthening the leaflets’ wording on suicidal behaviour. It also “recommended updates to the PILs for certain antidepressants to better reflect patient feedback and emerging evidence on the potential for sexual dysfunction that may continue after stopping treatment”. It adds: “Patients should continue taking their medicines as prescribed and not stop or change treatment without first speaking to a doctor or mental health professional”. The page names NHS 111 and the Samaritans on 116 123.
6. NHS, Fluoxetine, page last reviewed 1 June 2026: “Call NHS 111 if” you’re “having thoughts about harming yourself”. NHS, Antidepressants, page last reviewed 12 June 2025: “Call 999 or go to A&E immediately if you are in danger or do not feel you can keep yourself safe”; problems with sex “may carry on after stopping antidepressants”. Both read 12 October 2026.
7. European Medicines Agency, positive opinion for the use of Prozac in children and adolescents, press release, 6 June 2006 (EU). The company “will also put in place a system to obtain safety data in treated children, in particular regarding sexual development”. Also read: Prozac’s US prescribing information, revised August 2023, section 8.4: “there are no studies that directly evaluate the longer-term effects of fluoxetine on the growth, development and maturation of children and adolescent patients”.
8. Levine A, McGlinchey E. Assessing sexual symptoms and side effects in adolescents. Pediatrics 2015;135(4):e815-7. A commentary, not a study, from the Division of Child and Adolescent Psychiatry, Columbia University. Of the large trials of fluoxetine and sertraline in under-18s: “the trials did not routinely evaluate sexual symptoms and side effects”. An earlier review reached the same view: Scharko AM. Selective serotonin reuptake inhibitor-induced sexual dysfunction in adolescents: a review. J Am Acad Child Adolesc Psychiatry 2004;43(9):1071-9. “Information on SSRI-induced sexual dysfunction in adolescents is lacking.”
9. Ben-Sheetrit J, Hermon Y, Birkenfeld S and colleagues. Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants. Ann Gen Psychiatry 2023;22:15. Health records of men aged 21 to 49 in Israel; the authors list the focus on men and on erection problems as limits. A review found no reliable estimate: Tarchi L, Merola GP, Baccaredda-Boy O and colleagues. Selective serotonin reuptake inhibitors, post-treatment sexual dysfunction and persistent genital arousal disorder: a systematic review. Pharmacoepidemiol Drug Saf 2023;32(10):1053-67.
10. MHRA, Yellow Card scheme, How to report, read 12 October 2026. Reports come from “the public (including patients, parents, and carers)”. “You can report for yourself or for someone else, with their permission”. Yellow Card Centre Wales, reporting for patients, carers and the public, lists “Your child” among those you can report for.
11. YoungMinds, Parents Helpline, for the parent or main carer of anyone aged 25 or under, across the UK: “It is free and confidential”. When we read the page on 12 October 2026, the service was email-only for the time being.
12. Moral Medicine, interview with Jevin, 1 July 2024 (40 minutes). All from the YouTube auto-captions. He is 26 (1:15, 4:50). Up late crying at 10, and counselling that didn’t get far (3:10 to 3:39). A psychiatrist and Zoloft at 11 (3:39 to 4:00). On and off antidepressants until about 25 (4:37 to 4:44). Off “for a little over a year now”, and 25 before he knew about PSSD (4:53 to 5:03). The label and “some of it I thought was just me or just my personality or just a quirk about me” (5:46 to 6:00). “My mom was there the whole time. She was a lifeline for me” (16:56 to 17:03). Improvements: “not really” (33:28 to 33:33). He believes he can get better (37:45 to 37:51). His story on our site: Jevin’s story: first prescribed at 11.
13. MHRA, Yellow Card - How to report, 12 November 2024 (93 seconds).