Working with PSSD: adjustments and your rights

Is work harder since you stopped an antidepressant? In the UK you can ask your employer for changes to how you work, and you only tell them as much as you choose.

Post-SSRI sexual dysfunction (PSSD) can last after stopping, and for some people it makes work harder. People describe trouble concentrating, a foggy head, poor sleep and a flat mood that makes it hard to care about tasks.

PSSD is more than sexual problems. The criteria proposed in 2022 list “cognitive impairment” and “emotional numbing” among its symptoms. Neither shows on the outside, so colleagues may not see why a meeting or a deadline has become harder.

The UK leaflet for Cipralex (escitalopram) says sexual problems have, in some cases, “continued after stopping treatment”. Nobody has measured how often that happens, or how many people it keeps from working.

So what do you need to tell your employer, and what can you ask for?

Do I have to tell my employer about PSSD?

GOV.UK guidance doesn’t say you must. You can describe what affects your work without naming the condition or going into sexual symptoms.

Many people find it easier to start with the practical effect. You might say: “I have a health condition that affects my concentration and energy, especially in the mornings. These changes would help me do my job well.”

If you want the condition on record, a short letter from your GP can help. Our letter for your doctor explains PSSD in a page your GP can read.

What adjustments can I ask for?

Employers must make reasonable adjustments so disabled workers are “not substantially disadvantaged when doing their jobs”, according to GOV.UK.

There’s no research on PSSD and work specifically. What follows comes from UK employment guidance, which applies to many health conditions. Our page on brain fog in PFS and PSSD has more on the cognitive side.

The guidance gives examples. Several fit symptoms like brain fog and fatigue:

• Doing things another way: a quiet desk instead of hot-desking, written notes after meetings.
• Flexible hours: starting later if mornings are worst.
• Working somewhere else: from home on some days.
• A phased return: part-time hours for a while after time off.

Ask in writing, say what you need and why, and keep a copy. If your employer says no, ask for the reason in writing.

Does the Equality Act cover PSSD?

It might. The law looks at how a condition affects you, not at its name, and PSSD isn’t listed.

Under the Equality Act 2010, a disability is “a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect” on everyday activities. Substantial means “more than minor or trivial”. Long-term means “12 months or more”.

Whether PSSD meets that depends on your symptoms and how long they last. Only a tribunal can decide it for certain. For advice on your situation, Acas and Citizens Advice are free. This is UK law; other countries have their own rules.

What help is there beyond my employer?

Yes. Access to Work is a UK government scheme that “can help you get or stay in work if you have a physical or mental health condition or disability”.

It can pay for practical support such as equipment, software or travel if you can’t use public transport. Its mental health support, run by Able Futures or Maximus, can include one-to-one sessions with a mental health professional and a plan to help you stay in work.

If you need time off, your GP can give you a fit note. It can say you’re not fit for work, or that you may be fit with changes such as altered hours.

Rosie, president of the PSSD Network, talks about living with PSSD in her interview. In the short video below, Professor Joanna Moncrieff, a psychiatrist at UCL, talks about how aware doctors are of PSSD. It’s background for a GP visit, and says nothing about work.

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

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly.

Write down what changed and when: “Sertraline 50 mg from January 2023, last tablet March 2024. Since then I lose track in meetings and feel flat most days.”

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?

Can I work with PSSD? Many people do, often with changes to hours, tasks or where they work. Some need time off first. What helps depends on your symptoms, and they can change over time. Our page on recovery from PSSD covers what is known.

Should I tell colleagues? That’s your choice. You can keep it between you and your manager or HR. Some people tell one trusted colleague so someone understands a bad day. Others in the WhatsApp peer support groups share how they handled it.

You don’t have to work this out alone. Start with one written request to your employer, and see our PSSD page for the basics to share.

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 from expert agreement. Section 3: “An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops”; ancillary symptoms “may include” “emotional numbing”, “other sensory problems” and “cognitive impairment”.
2. Lundbeck Limited. Cipralex (escitalopram) patient information leaflet, electronic Medicines Compendium, revised May 2025. Section 2: sexual problems “have continued after stopping treatment” in some cases.
3. GOV.UK. Definition of disability under the Equality Act 2010. UK (England, Scotland and Wales).
4. GOV.UK. Reasonable adjustments for workers with disabilities or health conditions.
5. GOV.UK. Access to Work.
6. GOV.UK. Report a problem with a medicine or medical device.
7. PSSD Network, Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction, June 2026. General context, not evidence about work.

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