Anhedonia in PFS and PSSD: what can help?

Can’t enjoy music, food or friends since taking finasteride or an antidepressant? Losing the ability to feel pleasure or joy is called anhedonia. Many people with post-SSRI sexual dysfunction (PSSD) or post-finasteride syndrome (PFS) describe it, and for some it can last long after the last tablet.

Matt took finasteride for three years. A few weeks after he stopped, he began to feel “very emotionally numb”. He says: “I wasn’t just not feeling sad, I wasn’t feeling any emotions at all.” Later he learnt the name for it: “anhedonia and emotional blunting”.

Play video: Matt on feeling emotionally numb after finasteride (extract)

So can it last, is it depression, and what can help?

What does anhedonia feel like?

It feels like the colour has drained out of life. Music, food, friends and hobbies are still there, but they don’t land. Some people call it emotional blunting or emotional numbness.

These conditions are more than sexual problems, even though the names suggest otherwise. The 2022 diagnostic criteria list emotional numbing, cognitive problems and other sensory changes alongside PSSD’s genital numbness.

Matt says the flatness first “felt like somewhat of a relief”, because he had always been very emotional. Then he noticed that good feelings had gone too. Other people describe pleasure missing from sex as well, sometimes called genital anhedonia, where orgasm happens with little or no pleasure.

Because it’s hard to see from outside, people around you may not understand it. That can make it lonely.

Can anhedonia last after stopping the medicine?

Yes, for some people it has. The UK leaflet for Cipralex (escitalopram) says sexual problems have in some cases “continued after stopping treatment”. The UK Propecia (finasteride) leaflet lists a “persistent decrease in sex drive after discontinuation of treatment”. Neither leaflet uses the word anhedonia.

The 2022 criteria say emotional numbing or depersonalisation “may be a person’s main complaint in primary care”.

For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. Five years on, Matt says his emotions “are still completely blunted”. Others say theirs eased slowly.

Nobody has measured how often emotional blunting happens. In one collection of 300 reports of lasting sexual problems after these medicines, about 1 in 5 people also described emotional blunting.

Those people chose to report to a drug-safety website, and there was no comparison group. So the figure tells us the symptom is part of the picture. It can’t give a rate for everyone who takes the medicine.

Is it depression or something else?

It can be hard to tell, and it can be both. The NHS lists “not getting any enjoyment out of life” as a symptom of depression. People with PSSD and PFS often say their numbness feels different: less sadness, more absence.

You don’t need to settle this alone. Describe what changed, and when, and let your GP help sort out what else could explain it.

What helps with anhedonia?

No treatment has been tested for anhedonia in PSSD or PFS. People in our community say these help them cope.

• Gentle movement. A walk, a short run or light weights. Start slowly and see how your body responds.
• A simple routine. Small, regular plans give the day a shape, even when the reward feels muted.
• Small steps back into old interests. Do them for a few minutes without expecting to enjoy them.
• A journal. Note sleep, mood and good moments. It helps you spot patterns and gives your GP something concrete.
• Less alcohol and fewer drugs. Many people find they make things worse.
• Talking therapy. Ask your GP about it. It won’t fix the cause, but it can help with the weight of living with it.
• People who understand. Our WhatsApp groups connect you with others living with this.

In this short video, Professor Joanna Moncrieff, a psychiatrist at UCL, says many people with PSSD describe feeling numbed in their emotions, and that doctors may not know about it. It’s useful background before a GP visit.

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 an antidepressant suddenly. The finasteride leaflet says to stop and see your doctor if your mood changes.

Many people say it took time to be taken seriously. Bring the leaflet line. If numbness turns into thoughts of ending your life, call the Samaritans on 116 123, any time, or ask for an urgent GP appointment.

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 an SSRI or SNRI, write Post-SSRI sexual dysfunction (MedDRA 10086208). After finasteride or dutasteride, write Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430). Then describe the emotional numbness in your own words.

Our reporting guide walks you through it

What else do people ask?

Is anhedonia in PFS or PSSD permanent? For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease. Some people describe slow improvement over years, so keep a record of how you feel.

Can I have anhedonia without sexual symptoms? For finasteride, the 2022 criteria say cognitive problems, depression and suicidal thoughts can occur without any sexual problems. For PSSD, emotional numbing usually comes with genital numbness, but it may be the main thing a person notices.

Should I tell people close to me? That’s your choice. Many people find it helps to explain that the flatness isn’t about them. Our article on talking to family and friends about PFS has ideas.

Matt learnt the name for what he felt from other patients. If this sounds like you, start with our PSSD or PFS page, and tell someone.

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. Expert consensus. Section 3: “Ancillary non-sexual symptoms may include: emotional numbing, depersonalization, other sensory problems involving skin, smell, taste or vision, cognitive impairment”; “Emotional numbing or depersonalization may be a person’s main complaint in primary care”. Section 5: cognitive impairment, depression and suicidality listed as finasteride effects “that can occur independently of any sexual difficulties”. “The incidence of these conditions is unknown.” The paper does not use the word anhedonia.
2. Lundbeck Limited. Cipralex (escitalopram) patient leaflet, EMC, revised May 2025. Section 2: sexual problems “have continued after stopping treatment” in some cases.
3. Organon. Propecia (finasteride) 1 mg patient leaflet, EMC 2194. Section 2, mood alterations warning: “If you experience any of these symptoms stop taking Propecia and contact your doctor”. Section 4, frequency unknown: “persistent decrease in sex drive after discontinuation of treatment”.
4. Healy D, Le Noury J, Mangin D. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases. Int J Risk Saf Med 2018;29(3-4):125-134. Emotional blunting described in 60 of 300 reports to RxISK.org. Self-selected reports, no comparison group: not a rate.
5. NHS. Symptoms of depression in adults: “not getting any enjoyment out of life”.
6. GOV.UK. Report a problem with a medicine or medical device. Samaritans, 116 123.
7. Moral Medicine. Matt’s film, 6 April 2026, quoted from YouTube auto-captions (5:32 to 6:22; “still completely blunted” at 9:25). His story: Matt’s story.
8. PSSD Network. Professor Joanna Moncrieff discusses PSSD, June 2026. Paraphrased from 1:13 to 1:28. General context.

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