Depersonalisation after SSRIs: can it last?

Feeling detached from yourself since taking an antidepressant, as if you’re watching your life from outside? That feeling, depersonalisation, is a listed side effect in the leaflets for some antidepressants, such as fluoxetine (Prozac). For some people it can last after stopping, as one of the symptoms of post-SSRI sexual dysfunction (PSSD).

The NHS page that explains depersonalisation lists causes such as trauma and stress, but no medicine. So it’s easy to blame anxiety, even when the leaflet in your own pack names the feeling.

Stephen took escitalopram (Lexapro) for 15 years without trouble. He came off it slowly and felt well for about seven months. Then he went back on a low dose for six days, and stopped again. Here he describes what came next: the numbness and the unreal feeling arrived together.

Play video: Stephen on what began after he stopped escitalopram (extract)

A week and a half later, he says, his genitals went numb and he stopped feeling anything for his family. And “this severe, severe, horrific derealisation” kicked in.

So is this a known side effect, and can it last?

Is feeling detached a side effect of antidepressants?

Yes, and it’s printed in the leaflets. The UK leaflet for Efexor XL (venlafaxine) lists “feeling separated (or detached) from yourself” as common, which means it may affect up to 1 in 10 people. A UK fluoxetine leaflet calls it uncommon. The leaflets for Seroxat (paroxetine) and Cipralex (escitalopram) list it under “rare”.

Each of those leaflets also warns that sexual problems have, in some cases, “continued after stopping treatment”. None says that about feeling detached.

The link isn’t new. In 1991 a psychiatry journal published a short report called “Depersonalization syndrome induced by fluoxetine”.

Depersonalisation has a close relative, derealisation: the world feels unreal, and people and things may seem “lifeless” or “foggy”, the NHS says. You can have one or both.

Could it be withdrawal?

It could, especially in the first weeks. The NHS lists feeling “like things are not real” among the symptoms of coming off an antidepressant. These usually start within a few days and fade within a few weeks, it says. For some people they last months or longer.

Amanda, a nurse in the US, felt it while slowly coming off escitalopram. She describes it almost the way the NHS does.

Play video: Amanda on feeling unreal while coming off escitalopram (extract)

“I felt like I was watching other people’s lives and that I was not real,” she says.

1

While you take it

A listed side effect in at least four UK leaflets.

2

While you come off it

A withdrawal symptom. Usually weeks, sometimes months or longer.

3

Months after the last tablet

It can be part of PSSD, if genital feeling has changed too.

Timing helps tell them apart. The PSSD checklist says that once sexual problems have lasted three months after stopping, PSSD is more likely. PSSD or withdrawal? covers the other differences.

Can depersonalisation last after stopping an SSRI?

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

PSSD can follow SSRI antidepressants, the group fluoxetine belongs to, and similar ones such as venlafaxine. It’s more than a sex problem, even though the name says so. In 2022 doctors and researchers agreed a checklist to recognise it. At its centre is a lasting change in how the genitals feel, often numbness.

The checklist’s other symptoms include depersonalisation, emotional numbness and problems with concentration and memory. Touch, smell, taste or sight can change too.

Stephen took his last tablet in autumn 2023. When he was interviewed nearly three years later, the feeling hadn’t let up.

Play video: Stephen on living with derealisation (extract)

It “feels like I’ve been drugged”, he says. He’s “not connected to the world around me”.

On its own, feeling detached isn’t PSSD. The checklist needs a lasting change in how the genitals feel, and lists feeling detached among the symptoms that can come with it. Its authors point out that strong depersonalisation can also happen on medicines that don’t cause sexual problems.

They also say feeling detached may be the main thing someone mentions to their GP. A change in genital feeling can pass for simply wanting sex less. So if you’ve felt unreal since your last tablet, notice whether touch feels different too. Our page on genital numbness describes what that can feel like.

What can I do?

These medicines help many people. What to do about side effects is a decision for you and your prescriber. Don’t stop suddenly.

Tell your GP what you feel, in your own words, such as “I feel like I’m watching my life from outside”. Give your dates too: “Venlafaxine 75 mg from June 2021, last capsule March 2024”. Mention any change in sex or genital feeling, even if it feels awkward to say.

Feeling unreal for months can be frightening. If you ever feel you can’t go on, call Samaritans free on 116 123, day or night.

Many people say it took time to be taken seriously. Bring a photo of the leaflet line. You can report it yourself, without a doctor agreeing.

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. Our Yellow Card guide for PSSD shows each step.
• 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 as emotional numbness? No, though one person can have both, as Stephen does. Emotional numbness turns your feelings down. Depersonalisation is more like watching your feelings from a distance. Emotional blunting on SSRIs covers the numb side.

Could it be my anxiety or depression? It can be. The NHS says dissociation (feeling cut off like this) is one way the mind copes with too much stress, and it can come with anxiety or depression. Tell your GP whether it began before the tablets, while you took them or after you stopped.

Can I report it if sex feels the same? Yes. You can report any side effect you suspect, without proof. Write it in your own words, such as “I feel detached from myself”, and say when it started.

Stephen still knows the exact day his symptoms began. If you’ve felt unreal since your last tablet, write down when it started and report it, even years later. Our PSSD page explains the rest of the condition.

Sources

1. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria agreed by an expert panel; read in full. PSSD necessary criterion 2: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”. Ancillary non-sexual symptoms “may include” “emotional numbing”, “depersonalization”, “other sensory problems involving skin, smell, taste or vision” and “cognitive impairment”. On depersonalisation: it “may be a person’s main complaint in primary care”, and “marked depersonalization can happen on drugs that do not cause sexual dysfunction”. Genital changes “may be hidden beneath symptoms of loss of sexual desire or arousal”. Timing: “once dysfunction lasts for three months, it is more likely to be PSSD”. Introduction: “The incidence of these conditions is unknown”.
2. Efexor XL (venlafaxine) prolonged-release capsules, patient leaflet, Electronic Medicines Compendium (EMC 5474), last revised October 2025. Section 4, common (may affect up to 1 in 10 people): “feeling separated (or detached) from yourself”; uncommon: “feeling separated (or detached) from reality”. Section 2: sexual symptoms “have continued after stopping treatment” in some cases.
3. Fluoxetine 20 mg hard capsules, patient leaflet, EMC 15755, last revised September 2022. Section 4, uncommon (may affect up to 1 in 100 people): “feeling detached from yourself”. Section 2: “In some cases, these symptoms have continued after stopping treatment.”
4. Seroxat (paroxetine) film-coated tablets, patient leaflet, EMC 7592, last revised October 2024. Section 4, rare (may affect up to 1 in 1,000 people): “Feeling detached from yourself (depersonalisation)”. Section 2: the same continued-after-stopping line.
5. Lundbeck Limited. Cipralex (escitalopram) film-coated tablets, patient leaflet, EMC 7718, revised May 2025. Section 4, rare (may affect up to 1 in 1,000 people): “Aggression, depersonalisation, hallucination”. Section 2: the same continued-after-stopping line.
6. Black DW, Wojcieszek J. Depersonalization syndrome induced by fluoxetine. Psychosomatics 1991;32(4):468-9. A short case report; read as its PubMed record only (no abstract).
7. NHS. Antidepressants. Page last reviewed 12 June 2025. Withdrawal symptoms include feeling “like things are not real”. They “usually begin within a few days” and “last for a few weeks”. For some people they “start weeks or months later, and last for months or longer”. On this page, the feeling appears only among withdrawal symptoms.
8. NHS. Dissociative disorders. Page last reviewed 14 August 2023. Depersonalisation: “the feeling of being outside yourself and observing your actions, feelings or thoughts from a distance”. Derealisation: “you feel the world is unreal”, and people and things “may seem ‘lifeless’ or ‘foggy’”. Also: “Dissociation is a way the mind copes with too much stress”. The page lists no medicine among the causes; it mentions antidepressants only as a treatment for associated conditions such as depression and anxiety.
9. Moral Medicine. I Took Lexapro for 15 Years Without a Problem. Six Days Changed My Life Forever, interview with Stephen, 20 July 2026. Quoted from YouTube’s automatic captions: 6:22 to 6:26 (“derealisation”), 45:46 to 45:53 (“drugged”, “not connected”), 37:53 to 38:22 (last dose, end of September or early October 2023; symptoms began on a day he names), 16:05 (“approaching 3 years”). His story on our site: Stephen’s story.
10. Moral Medicine. I Lost Myself on Lexapro: A Nurse’s Story of Withdrawal, Identity, and Survival, interview with Amanda, 24 November 2025. Quoted from YouTube’s automatic captions, 17:38 to 17:45. Her story on our site: Amanda’s story.

Sources checked on 27 October 2026. AI-assisted writing and review, not clinical review.