I think I have PSSD: what should I do?

Think you might have post-SSRI sexual dysfunction (PSSD)? Start by writing down your medicine, your dates and what has changed. Then take that to your GP.

Don’t stop or change your antidepressant suddenly. You can also report it, and talk to people who have been where you are.

The UK leaflet for Cipralex (escitalopram) says sexual problems have, in some cases, “continued after stopping treatment”. You aren’t imagining it, and you aren’t the first.

So what are the first signs, and what should you do next?

What are the first signs of PSSD?

People often notice it after stopping or cutting down, though it can start while still taking the medicine. Common descriptions are touch that feels numb, orgasm with little or no pleasure, and less desire.

PSSD can last after stopping an SSRI or SNRI antidepressant, and it’s more than sexual problems. The 2022 criteria describe a lasting change in genital sensation, often numbness, and also list emotional numbing, problems with cognition and changes in other senses.

Many also describe feeling flat. Music, food or people they love don’t land the way they used to. Some have cognitive problems. The 2022 diagnostic criteria list these non-sexual symptoms alongside the genital ones.

Early on, it can be hard to tell PSSD from withdrawal. The criteria say ordinary side effects “may linger for some days or weeks”, and once problems last three months, PSSD is more likely. Our guides on PSSD or withdrawal and how PSSD is diagnosed go into more detail.

Should I stop my antidepressant?

That’s a decision for you and your prescriber. Don’t stop suddenly.

The Cipralex leaflet says: “Do not stop taking Cipralex until your doctor tells you to do so.” When treatment ends, it says the dose is “gradually reduced over a number of weeks”, because stopping fast raises the risk of withdrawal symptoms.

These medicines help many people. If you’re still taking yours, or recently stopped, talk to your prescriber before changing anything. Many people in our community say a slow, planned reduction felt safer than a sudden stop. That’s their experience, not a guarantee.

How do I talk to my GP about PSSD?

Bring a short record, so the appointment starts with facts:

1. Your medicine: “Sertraline 50 mg from January 2023, last tablet March 2024.”
2. What changed: “Touch feels numb”, “orgasm with no pleasure”, “I feel emotionally flat.”
3. When it started: before, while taking it, or after stopping.
4. How it was before: “No problems before 2023.”
5. Anything else they’ll ask about: other medicines, alcohol, diabetes, the menopause.

Bring the leaflet line too. Our letter for your doctor can help.

There is no blood test for PSSD. Tests can rule out other causes, and a normal result doesn’t rule PSSD out. Our page on PSSD blood tests explains what they show.

Watch: understanding PSSD

If you want something to share with family or your GP, Professor Joanna Moncrieff, a psychiatrist at UCL, talks about PSSD and how aware doctors are of it. It’s general background and doesn’t cover your own case.

Play video: Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction (PSSD)

How do I cope in the first weeks?

The first weeks after a crash can feel frightening. Fear is a normal reaction, and it can make it harder to think, so take things one step at a time.

• Tell someone you trust. A friend or relative doesn’t need every detail. “I’m going through something hard and could use support” is enough.
• Protect your sleep. Sleep is often disrupted. Keep the same bedtime and waking time, and avoid caffeine late in the day.
• Look after the basics. Eat regularly, drink water, and get fresh air or light exercise if you can. Some people find alcohol makes them feel worse.
• Don’t make big decisions in the first panic. Medicine changes belong with your prescriber.

If you have thoughts of harming yourself, call Samaritans on 116 123 (UK, free, day or night), or your local emergency number.

Talking to people who understand often helps most. Our WhatsApp peer support groups are run by people affected by PSSD, PFS and PAS. They share what has helped them cope and what to ask doctors.

Rosie, president of the PSSD Network, talks about her own PSSD in her interview on our site. In this extract she describes what it’s like to live with it.

Play video: Interview with Rosie, PSSD Network President

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 PSSD permanent? For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. Nobody has measured how often it happens, which is why reports matter.

What if my doctor doesn’t believe me? Many people say it took time to be taken seriously. Bring your written record and the leaflet line, and ask what else could explain it. You can report it without a doctor agreeing.

Can women get PSSD? Yes. Women describe genital numbness, loss of arousal and orgasm with little pleasure, alongside the emotional changes. Our page on PSSD in women covers what they describe.

Write your record tonight, and bring it to your GP. Our PSSD page is the place to start reading.

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 developed through expert agreement. Section 3: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”; ancillary symptoms include “emotional numbing”, “other sensory problems” and “cognitive impairment”. Section 9: side effects “may linger for some days or weeks”; “once dysfunction lasts for three months, it is more likely to be PSSD”.
2. Lundbeck Limited. Cipralex (escitalopram) patient information leaflet, electronic Medicines Compendium (UK). Section 2: sexual problems “have continued after stopping treatment” in some cases. Section 3: “Do not stop taking Cipralex until your doctor tells you to do so”; the dose is “gradually reduced over a number of weeks”.
3. GOV.UK. Report a problem with a medicine or medical device.
4. PSSD Network, Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction, June 2026. General context.
5. Moral Medicine, Interview with PSSD Network President Rosie, 9 July 2024.

Sources checked on 22 October 2026. AI-assisted writing and review, not clinical review.