Post-drug syndromes: do they start under 25?

Post-drug syndromes are side effects that last after stopping a medicine: PSSD after antidepressants, post-finasteride syndrome (PFS), and post-Accutane syndrome (PAS) after isotretinoin. Some start under 25, but nobody can say how many: published reports come mostly from adults, and few records give the age when it began.

Journalists ask us how old the patients are. A side effect report can come years after the first dose, so the age on it may not be the age when it began.

Jevin was 11 when he and his mother saw a psychiatrist, and he started an antidepressant. He was 26 when he told his story on camera.

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

His emotions flattened and he began to speak in a monotone, he says: “All this was attributed to just depression.” Jevin has PSSD, and he counts it from that first prescription: 15 years. A side effect report sent on the day of filming would have given his age as 26.

Which of these medicines do young people take?

Isotretinoin is the one taken mostly by the young. It treats severe acne, and acne peaks at about 17. A UK expert review expects use to be highest between 15 and 25, though it had no data on the age of UK patients.

Finasteride 1 mg, the hair-loss tablet, is for adult men. Its trials were in men aged 18 to 41, and the UK medicines regulator says those who take it “usually are young men”. It’s available only on private prescription, and the regulator said in May 2026 that accurate prescription numbers are not available.

Antidepressants are taken at every age. In England in 2025/26, about 7 in 100 patients prescribed one on the NHS were under 25, by our count from NHS prescription data, and the largest group was aged 55 to 59. That counts everyone given an antidepressant that year, for any reason, whenever they started.

The youngest age on each UK leaflet

From 6

SertralineUnder 18, for obsessive compulsive disorder only.

From 8

FluoxetineFor moderate to severe depression.

From 12

IsotretinoinFor severe acne, after puberty has begun.

Adults

Finasteride 1 mgIt “should not be used in children”.

How old are people who report PSSD, PFS and PAS?

Mostly in their twenties and thirties, in the records we found. Each one counts people who came forward, so none can show how often it happens at any age.

For isotretinoin, the same UK review looked at reports of sexual side effects sent to the Yellow Card scheme, the UK’s system for reporting side effects. Where an age was given, it was typically 21.

For PSSD, New Zealand’s medicines regulator summed up the research in June 2026. In the patient surveys and side effect reports it describes, the typical age is about 30.

For finasteride we found no typical age. The reports of sexual side effects sent to the UK regulator gave ages from 18 to 81, with the hair-loss dose and the higher dose counted together. A US study interviewed men aged 21 to 46.

How old were they when it began?

Few records say. Some people give their age when they started the medicine, the UK review found, and others their age when they reported, which “could be many years after their treatment”. That makes it “difficult to draw conclusions about age”, the review says.

One collection of 300 reports gives a count. They were sent between 2012 and 2017 to a website the researchers run, by people aged 15 to 66 with lasting side effects after medicines of these three kinds. In 16, the person said it began before the age of 18. That’s a count of people who chose to write in, so it can’t show how often it happens.

Lucas was 18 when he took finasteride, which a doctor had prescribed for his hair loss. He was 37 when he was filmed.

Play video: Lucas on why he took finasteride at 18 (extract)

“I was so young,” he says in the film. Joseph took isotretinoin at 13, Stefan at 15 and Elliot at 17. Each told his story later, looking back.

What can I do?

If you’re writing about this, say which age you mean: at the first dose, or on the day of the report. The press page offers interviews, data and introductions to patients and researchers. Everyone named here has told their story in public.

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. For finasteride and isotretinoin, follow what the leaflet says.

If you were young when it began, put both ages in your report: “Isotretinoin from March 2015, aged 16. Last capsule August 2015. I’m 27 now.”

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) for an SSRI or SNRI, or Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430) for finasteride. For isotretinoin there’s no term yet, so say the symptoms continued after stopping. Our article on the codes explains them.

Our reporting guide walks you through it

What else do people ask?

What is a post-drug syndrome? Symptoms that continue, or first appear, after a medicine is stopped. The UK leaflets for sertraline, finasteride and isotretinoin each say that some side effects can continue after stopping. SIDEfxHUB is a post-drug syndrome charity with a focus on PFS, PSSD and PAS. Our page on post-drug syndromes explains more.

Are young people more at risk? Nobody knows. On isotretinoin, the UK review said specific increased risks “were not identified within the under 18 age group”, and called for closer oversight until there were more data. More in finasteride in your teens and twenties, what parents ask about isotretinoin and the UK rules for under-18s.

Can under-18s be prescribed antidepressants? Some can. The UK leaflets allow fluoxetine from the age of 8 for depression, and sertraline from 6 for obsessive compulsive disorder. NHS data count about 63,600 under-18s in England who were prescribed an antidepressant in 2025/26, for any reason. More in antidepressants in teens.

Jevin was 26 on camera, and 11 at his first prescription. If you report, give both of yours.

Sources

1. Commission on Human Medicines, Report of the Isotretinoin Expert Working Group, 26 April 2023, published by the MHRA. Section 4.2.6: “Peak age range for Yellow Card reports of psychiatric side effects is 15 to 25 years which reflects the age range where usage of isotretinoin would be highest”, and peak age for acne “approximately 17 years”. Section 6.7: “It is difficult to estimate usage of isotretinoin in the UK and no data is available on the age of patients receiving treatment”. Section 5.3.1, table 2: 184 Yellow Card reports of sexual side effects up to 20 May 2021, a valid age in 160, range 14 to 50, median 21. The same section says some patients gave their age when they started and others when the side effect began. Some gave it “at the time of their report, and this could be many years after their treatment”, so “it is difficult to draw conclusions about age”. Section 8.3: specific increased risks “were not identified within the under 18 age group”, with greater oversight advised “until further data on the level of risk could be established in this age group”.
2. NHS Business Services Authority, Medicines Used in Mental Health, England, 2016/17 to 2025/26: antidepressant drugs, published 23 July 2026, and its financial year summary tables. Identified patients prescribed any antidepressant (BNF section 4.3) in 2025/26, by age band: 624,992 aged under 25 out of 9,055,378 with a recorded age, which is 6.9%. That sum of the age bands is ours; the NHSBSA’s tables note that adding patient counts together “is likely to result in an overestimate of the number of patients”. The same total comes from its own split into 17 and under (63,609) and 18 and over (8,991,769). The largest band was 55 to 59 (894,406). The figures cover NHS prescriptions dispensed in the community, for any reason, and every antidepressant, of which SSRIs are one group. They count patients in the year. We found no official figure for age at first prescription.
3. MHRA, Safety review of finasteride: public assessment report, April 2024. The men on the 1 mg dose “usually are young men using finasteride for hair loss”. Section 5.2: 375 Yellow Card reports of sexual dysfunction up to 5 January 2023, both doses together; “The age range of reports was from 18 to 81 years”. The MHRA’s Drug Safety Update of 11 May 2026 says that for the 1 mg dose “accurate prescription numbers are not available”.
4. Propecia 1 mg film-coated tablets, patient leaflet (UK, EMC 2194), last revised May 2026: “Propecia should not be used in children”, and persistent sexual problems “after discontinuation of treatment”. Its summary of product characteristics, section 5.1: clinical studies in 1,879 men aged 18 to 41.
5. Lustral (sertraline), patient leaflet (UK, EMC 2835), last revised December 2025: for children and adolescents aged 6 to 17 only for obsessive compulsive disorder; “In some cases, these symptoms have continued after stopping treatment”. Fluoxetine 20 mg capsules, patient leaflet (UK, EMC 15755), revised September 2022: children and adolescents aged 8 and above, for moderate to severe depression; the same sentence on sexual symptoms.
6. Roaccutane 10 mg and 20 mg soft capsules, patient leaflet (UK, EMC 100633), last revised April 2026. It “should not be used to treat prepubertal acne and not in children aged less than 12 years of age”. Side effects are generally reversible, “however some may continue after treatment has stopped”.
7. Medsafe, Update on sexual dysfunction following discontinuation of serotonin reuptake inhibitors, paper for the Medicines Adverse Reactions Committee, 11 June 2026. Section 3 describes 86 reports to the Dutch centre Lareb of sexual problems that had not resolved after stopping an SSRI: median age 32, range 14 to 66. An international online survey of 239 adults (Studt and colleagues, 2021) had a median age of 29 for men and 30 for women. A survey of 135 people had a mean age of 31.9, range 19 to 59. These are ages at the time of the report or survey.
8. Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med 2011;8(6):1747-53. Standardised interviews with 71 men aged 21 to 46 who reported sexual side effects lasting at least 3 months after stopping. The authors list selection bias among the limits.
9. 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):125-34. Reports sent to RxISK.org, a website set up by the authors and colleagues, between 2012 and 2017. “Age details were supplied by 295 subjects, ranging from 15 to 66 years”. “In 16 cases, onset of the condition was reported to have occurred under the age of 18”. Mean ages by group ran from 23 to 32. People chose to report, so the series can’t show how often this happens.
10. Moral Medicine, interview with Jevin, 1 July 2024 (41 minutes; the title is the channel’s). Our page plays the first 46 seconds. All from the YouTube auto-captions. “It starts at age 11 so I’m 26 now”, and he counts it as 15 years (0:00 to 0:07, again at 1:11). His emotions flattened and he began speaking in a monotone (0:21 to 0:30). “All this was attributed to just depression” (0:39). The psychiatrist and the first prescription at 11 (3:39 to 4:02). His story on our site: Jevin’s story: first prescribed at 11.
11. Moral Medicine, interview with Lucas, 16 June 2026 (43 minutes). Our page plays an extract, 2:09 to 3:47. From the YouTube auto-captions: hair loss from 16 or 17 and the doctor’s prescription (2:10 to 2:28); taking it at 18, and 37 now (3:25 to 3:34); “since I was so young” (3:40). His story on our site: Lucas’s story: finasteride at 18.
12. On our site, from Moral Medicine’s interviews: Joseph’s story: isotretinoin at 13 (17 November 2025), Elliot’s story: Accutane at 17 (28 January 2025) and Stefan’s story: Accutane at 15 (11 December 2024).