Pristiq sexual side effects and PSSD
Pristiq (desvenlafaxine) can lower sex drive and cause erection and orgasm problems. Its Canadian leaflet warns this can last after stopping: PSSD.
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Pristiq (desvenlafaxine) can lower your sex drive and cause erection and orgasm problems. Its Canadian patient leaflet warns that in some cases these symptoms “have continued after stopping”, a condition known as post-SSRI sexual dysfunction (PSSD).
If you got Pristiq in the US, you may never have seen that sentence. The leaflet in a US pharmacy bag, called the Medication Guide, says Pristiq “may cause sexual problems” but not that they can continue after stopping. So if sex still feels different months after your last tablet, nothing you were given may have warned you.
Despite the name, PSSD covers SNRI antidepressants like Pristiq as well as SSRIs such as sertraline. It’s also more than a sexual problem. A checklist doctors and researchers proposed in 2022 puts a lasting change in how the genitals feel at its heart, often numbness. It also lists emotional numbing, problems with concentration and memory, and changes in skin, smell, taste or vision.
The story in 3 lines
- Pristiq can lower sex drive and cause erection and orgasm problems (US information for doctors).
- Desvenlafaxine leaflets in Canada and Spain warn these have sometimes continued after stopping (Pristiq's Canadian leaflet).
- We found no study that counts how often this happens after Pristiq. Patients call it PSSD, a name that covers SNRIs such as Pristiq too (2022 checklist).
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What sexual side effects does Pristiq cause?
Mostly a lower sex drive, erection problems and trouble reaching orgasm. The Canadian leaflet lists them as common: “abnormal ejaculation or impotence in men, decreases in sexual desire, performance and satisfaction”.
Pristiq’s US label is the official information for doctors. In the short trials behind it, about 3 in 100 men on the 50 mg dose said they had erection problems, against 1 in 100 on a dummy pill.
One trial, paid for by the maker, asked people directly about sex with a short questionnaire. After eight weeks, sexual problems were about as common on Pristiq as on a dummy pill. Like all these trials, it only measured sex while people were taking the tablets. None of them tells you what happens after you stop.
Can Pristiq’s sexual side effects last after stopping?
Yes, in some cases. Pristiq’s Canadian leaflet says so in plain words.
Pristiq's Canadian leaflet: “Effects on sexual function”
“Taking medicines like PRISTIQ may cause symptoms of sexual dysfunction. In some cases these symptoms have continued after stopping PRISTIQ treatment.”
In 2019 the EU medicines regulator asked for this warning in the leaflets of ten SSRI and SNRI antidepressants, desvenlafaxine among them. We found no study that has counted how often it happens after Pristiq.
For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.
Your own leaflet may not say so. Each country writes its own, even for the same medicine. Outside the US, as of October 2026:
- Canada: the patient leaflet has the warning.
- Spain: the two desvenlafaxine leaflets we checked have it too.
- Australia: the information for doctors has it. The leaflet in the pack, written in October 2023, lists sexual problems but not the warning.
- UK: Pristiq isn’t licensed here, says the MHRA, the UK medicines regulator. So there’s no UK leaflet.
Our page on PSSD warnings around the world shows which regulators have added the warning, and when.
Is Pristiq the same as Effexor?
No, but they’re close relatives. When your body breaks down venlafaxine (Effexor), the main active substance it makes is desvenlafaxine, the medicine in Pristiq, the US label says.
The UK leaflet for Effexor (sold as Efexor XL) carries the same warning about sexual problems continuing after stopping. Our page on Effexor and Cymbalta covers it, with the stories of two people who took Cymbalta.
Some people try more than one antidepressant. Cael was switched between six medicines, Pristiq and Effexor among them. He now lives with PSSD, says Moral Medicine, which films interviews with patients.
The checklist only asks whether you took a medicine from this family. You don’t have to know which tablet caused it. Our list shows which antidepressants are linked to PSSD.
What can I do?
These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. Don’t stop suddenly: the Canadian leaflet warns that stopping without talking to your doctor can cause dizziness, irritability and other unwanted effects.
If sex hasn’t gone back to how it was since your last tablet, tell your doctor. Give your dates: “Desvenlafaxine 50 mg from January 2023, last tablet March 2024.” Note any changes beyond sex too, such as feeling emotionally flat or struggling to concentrate.
Questions to take to your doctor
You could open with: “Pristiq's Canadian leaflet says sexual problems can continue after stopping. I think that's happened to me.”
- Could anything else explain these symptoms?
- Can my symptoms and the dates I took Pristiq go in my notes?
- Will you report this, or should I?
Many people say it took time to be taken seriously. Bring the leaflet line. You can report it without a doctor agreeing. In the US, the regulator is the FDA, and our guide to reporting to the FDA shows each step.
If your doctor hasn’t heard of PSSD, this 26-second extract may help. Professor Joanna Moncrieff, a psychiatrist at University College London, talks about PSSD in general.
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).
What else do people ask?
Can sexual problems start after stopping Pristiq?
It can happen with this family of medicines. The 2022 checklist, which covers SNRIs like Pristiq, says a lasting problem “may only appear when the drug is stopped”. If that happened to you, write down the date of your last tablet and the date you first noticed the change. Both matter to a doctor and in a report.
Does Pristiq affect women’s sex drive?
It can. The US label says women on SNRIs, Pristiq included, may want sex less, and find orgasm comes late or not at all. The Canadian warning about problems continuing after stopping doesn’t single out men or women. Our page on PSSD in women covers what women describe.
Could it just be my depression?
Depression itself often lowers sex drive, and our page on PSSD or depression explains how to tell them apart. A change in how your genitals feel, such as numbness, is different. The researchers behind the checklist say these changes in feeling “seem distinctive to PSSD”.
If sex has felt different ever since your last Pristiq tablet, report it. Our PSSD page explains what else the condition can bring.
Sources
- Pristiq (desvenlafaxine) extended-release tablets, prescribing information and Medication Guide, revised June 2025. DailyMed, US National Library of Medicine. Section 5.11, Sexual Dysfunction (men and women); section 6.1, Table 3, sexual function adverse reactions in pooled 8-week placebo-controlled trials (erectile dysfunction: placebo 1%, 50 mg 3%, 100 mg 6%, 200 mg 8%, 400 mg 11%); sections 10.1 and 11, “major active metabolite of venlafaxine”. The Medication Guide says Pristiq “may cause sexual problems” and has no sentence about symptoms continuing after stopping.
- Pristiq (desvenlafaxine) extended-release tablets 50 mg and 100 mg, product monograph, Pfizer Canada ULC, date of revision 12 February 2024. Health Canada, Drug Product Database. Section 7, Reproductive Health: Function; section 8.2, Table 4 (108 men on 50 mg, 239 on placebo); Part 3, Patient Medication Information: “Effects on sexual function”, “Other warnings you should know about” (stopping) and “Serious side effects”, common: “Sexual problems”.
- Desvenlafaxina Cinfa 50 mg comprimidos de liberación prolongada, prospecto, revised April 2022. CIMA, Spanish Agency of Medicines and Medical Devices. Section 2: “En algunos casos, estos síntomas persisten después de suspender el tratamiento.” Section 4 lists absent orgasm, lower libido, erectile dysfunction and delayed ejaculation as common. The Desvenlafaxina Stada 50 mg prospecto, revised September 2024, has the same sentence. CIMA lists ten desvenlafaxine generics from five companies.
- Pristiq, Consumer Medicine Information, Pfizer Australia, prepared October 2023: lists “sexual function problems” with no sentence about them continuing after stopping. Pristiq, Australian product information, revised 13 November 2025, section 4.4, Sexual Dysfunction: “symptoms have continued despite discontinuation of SNRIs”.
- MHRA, Antidepressants: use and safety, updated 15 October 2026. Section 3, footnote 2: desvenlafaxine and milnacipran “are not licensed in UK”.
- European Medicines Agency, PRAC, new product information wording, signals adopted at the 13-16 May 2019 meeting, EMA/PRAC/265221/2019. The wording is for ten medicines: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, desvenlafaxine, duloxetine, milnacipran and venlafaxine.
- Clayton AH, Tourian KA, Focht K, Hwang E, Cheng RF, Thase ME. Desvenlafaxine 50 and 100 mg/d versus placebo for the treatment of major depressive disorder: a phase 4, randomized controlled trial. J Clin Psychiatry 2015;76(5):562-9. Sponsored by Pfizer (NCT01432457). Eight weeks; sexual function was a secondary outcome, measured with the Arizona Sexual Experiences Scale in 422 people; no adjustment for multiple comparisons. Abstract: “Sexual function was comparable between desvenlafaxine and placebo.”
- 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. Section 3: SNRIs among the serotonin reuptake inhibitors; necessary criteria 1 and 2; ancillary non-sexual symptoms “emotional numbing”, “other sensory problems involving skin, smell, taste or vision” and “cognitive impairment”. Section 9: may “only appear when the drug is stopped”; reports of PSSD lasting “over two decades”; changes in genital sensation “seem distinctive to PSSD”.
- Tarchi L, Merola GP, Baccaredda-Boy O and colleagues. Selective serotonin reuptake inhibitors, post-treatment sexual dysfunction and persistent genital arousal disorder: a systematic review. Pharmacoepidemiol Drug Saf 2023;32(10):1053-67. No reliable estimate of how often it happens after SSRIs. Our own search of Europe PMC on 28 October 2026 found no study counting it after desvenlafaxine.
- Kennedy SH, Dickens SE, Eisfeld BS, Bagby RM. Sexual dysfunction before antidepressant therapy in major depression. J Affect Disord 1999;56(2-3):201-8. 134 people with depression, before any antidepressant: over 40% of men and 50% of women reported decreased sexual interest; no comparison group without depression.
- Efexor XL, UK patient information leaflet, section 2, “Sexual problems”, last revised October 2025.
- Picture: Pristiq pills.jpg by Tom Varco, CC BY 3.0, via Wikimedia Commons; scaled down and converted to WebP.
- Video: PSSD Network, Professor Joanna Moncrieff discusses Post-SSRI Sexual Dysfunction, June 2026, shown from 1:03 to 1:29. YouTube auto-captions: “their emotional functioning as well” and “their doctors may well not be aware of that”.
Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.
This information does not replace medical advice. Talk to your doctor before you make any decision about your treatment.
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Desvenlafaxine: what the official texts say, country by country
For the SNRI antidepressant desvenlafaxine (Pristiq), the product information we read in Canada says there have been reports of long-lasting sexual dysfunction where symptoms continued after SNRIs were stopped. This is known as post-SSRI sexual dysfunction (PSSD). The EU medicines regulator set the wording of this warning in 2019 for ten medicines, desvenlafaxine among them. In the United States, the Pristiq text for professionals has no such sentence.
This is a record of what each text says and of the date it prints. A text is quoted in its own words, or summarised where the row says so. It is not a comparison of countries. All medicines and countries
Desvenlafaxine: the official texts, country by country (19 texts read)
| Country or region | What the text says | Document | Dates |
|---|---|---|---|
| United Kingdom | We found no product with this medicine on 20 October 2026. | Text for professionalsWhere we looked: www.gov.uk/government/publications/antidepressants-use-and-safety--2/selective-serotonin-reuptake-inhibitors-ssris-and-serotonin-and-noradrenaline-reuptake-inhibitors-snris-use-and-safety | Checked |
| European Union | Sexual side effects that continue after stopping3. Serotonin and noradrenaline reuptake inhibitors (SNRI); selective serotonin reuptake inhibitors (SSRI) – Persistent sexual dysfunction after drug withdrawal (EPITT no 19277) · Summary of product characteristics · 4.4. Special warnings and precautions for use · Sexual dysfunction Sexual side effects that continue after stopping3. Serotonin and noradrenaline reuptake inhibitors (SNRI); selective serotonin reuptake inhibitors (SSRI) – Persistent sexual dysfunction after drug withdrawal (EPITT no 19277) · Package leaflet · 2. What you need to know before you take [Invented name] · Warnings and precautions The wording is for ten medicines: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, desvenlafaxine, duloxetine, milnacipran and venlafaxine. This is wording for national product texts. There is no single EU product text for this medicine. | Document from the regulator New product information wording – Extracts from PRAC recommendations on signals. Adopted at the 13-16 May 2019 PRACRead on the regulator's site: European Medicines AgencyAlso on record: 1 more related document, with such a sentence | PublishedChecked |
| United States | Sexual side effects, as listed5 WARNINGS AND PRECAUTIONS · 5.11 Sexual Dysfunction The same text also says5 WARNINGS AND PRECAUTIONS · 5.11 Sexual Dysfunction This text has no sentence about sexual side effects continuing after the medicine is stopped. This text names sexual side effects in several places that this row does not show. Together those passages are too long to reproduce here. The document link in this row opens the text. That they are not shown says nothing about how common these side effects are. On 20 October 2026 we searched the labels in openFDA, the FDA's open database. A sentence about sexual dysfunction continuing after stopping stood on none of the 75 labels in that database that name desvenlafaxine. | Text for professionals PRISTIQ® (desvenlafaxine) Extended-Release Tablets, for oral use: Full Prescribing InformationPristiq extended-release tablets 25 mg, 50 mg and 100 mg, Wyeth Pharmaceuticals LLC · Read in the government's medicines database: DailyMedAlso on record: patients' leaflet, with no such sentence | Text revisedChecked |
| Canada | Sexual side effects that continue after stopping7 WARNINGS AND PRECAUTIONS · Reproductive Health: Female and Male Potential · Function This text names sexual side effects in several places that this row does not show. Together those passages are too long to reproduce here. The document link in this row opens the text. That they are not shown says nothing about how common these side effects are. | Text for professionals PRODUCT MONOGRAPH INCLUDING PATIENT MEDICATION INFORMATION: PRISTIQ®, desvenlafaxine extended-release tabletsPristiq extended-release tablets 50 mg and 100 mg desvenlafaxine, Pfizer Canada ULC · Read in the regulator's own database: Drug Product DatabaseAlso on record: patients' leaflet, with such a sentence; 2 related documents, with such a sentence | Text revisedChecked |
| Australia | Sexual side effects that continue after stoppingSection 4.4 · Sexual DysfunctionSection 4.4 of Australia's product information for Pristiq has a warning headed sexual dysfunction. It says there are reports of sexual dysfunction that lasted a long time, with symptoms going on after SNRIs were stopped.Summarised, not quoted, because of the TGA's access terms. The regulator's site asks readers to accept its terms before it shows this text. | Text for professionals AUSTRALIAN PRODUCT INFORMATION – PRISTIQ DESVENLAFAXINE (as SUCCINATE) TABLETSPRISTIQ, Pfizer Australia Pty Ltd · Read in the regulator's own database: TGA eBSAlso on record: patients' leaflet, with no such sentence | Text revisedChecked |
| New Zealand | We could not open this text on 20 October 2026: the site did not answer. This says nothing about what the text contains. | Text for professionalsWe tried: www.medsafe.govt.nz/DbSearch/ | Tried |
| Germany | Sexual side effects that continue after stoppingPRAC-Meldungen · Neufassung des Wortlauts der Produktinformationen – Auszüge aus den Empfehlungen des PRAC zu Signalen · Serotonin- und Noradrenalin-Wiederaufnahmehemmer (SNRI); selektive Serotonin-Wiederaufnahmehemmer (SSRI) – persistierende sexuelle Funktionsstörung nach Absetzen von Arzneimitteln (EPITT Nr. 19277) The wording is for ten medicines: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, desvenlafaxine, duloxetine, milnacipran and venlafaxine. | Document from the regulator Bulletin zur Arzneimittelsicherheit – Informationen aus BfArM und PEI, Ausgabe 2 | Juni 2019Read on the regulator's site: BfArMAlso on record: text for professionals, could not be opened | PublishedChecked |
| France | We found no product with this medicine on 20 October 2026. | Text for professionalsWhere we looked: base-donnees-publique.medicaments.gouv.fr/ | Checked |
| Italy | Sexual side effects that continue after stopping4.4 Avvertenze speciali e precauzioni d’ impiego · Disfunzione sessuale Sexual side effects, as listed4.8 Effetti indesiderati · Disturbi psichiatrici · Comune Sexual side effects, as listed4.8 Effetti indesiderati · Disturbi psichiatrici · Non comune Sexual side effects, as listed4.8 Effetti indesiderati · Patologie dell'apparato riproduttivo e della mammella · Comune Sexual side effects, as listed4.8 Effetti indesiderati · Patologie dell'apparato riproduttivo e della mammella · Non comune The same text also says4.8 Effetti indesiderati The text itself prints no date of revision. The originator product is not in the list we read. This is another product from that list. A table cell or list line is shown whole, as the text prints it. Some of them also name side effects that are not sexual. | Text for professionals Riassunto delle caratteristiche del prodottoFaxilex 50 mg e 100 mg compresse a rilascio prolungato, Neuraxpharm Italy S.p.A. · Read in the regulator's own database: Banca Dati FarmaciAlso on record: patients' leaflet, with such a sentence | Made available by the regulatorChecked |
| Spain | Sexual side effects that continue after stopping4.4. Advertencias y precauciones especiales de empleo · Disfunción sexual Sexual side effects, as listed4.8. Reacciones adversas · Trastornos psiquiátricos · Frecuentes Sexual side effects, as listed4.8. Reacciones adversas · Trastornos psiquiátricos · Poco frecuentes Sexual side effects, as listed4.8. Reacciones adversas · Trastornos del aparato reproductor y de la mama · Frecuentes Sexual side effects, as listed4.8. Reacciones adversas · Trastornos del aparato reproductor y de la mama · Poco frecuentes The same text also says4.8. Reacciones adversas A table cell or list line is shown whole, as the text prints it. Some of them also name side effects that are not sexual. | Text for professionals Ficha técnicaPristiq 50 mg y 100 mg comprimidos de liberación prolongada, Pfizer, S.L. · Read in the regulator's own database: CIMAAlso on record: patients' leaflet, with such a sentence; related document, with such a sentence | Text revisedChecked |
| Brazil | Sexual side effects that continue after stopping5. ADVERTÊNCIAS E PRECAUÇÕES · Disfunção sexual Sexual side effects, as listed9. REAÇÕES ADVERSAS · Distúrbios psiquiátricos · Comum ≥1/100 a <1/10 Sexual side effects, as listed9. REAÇÕES ADVERSAS · Distúrbios psiquiátricos · Incomum ≥1/1000 a <1/100 Sexual side effects, as listed9. REAÇÕES ADVERSAS · Distúrbios do sistema reprodutivo e mamas · Comum ≥1/100 a <1/10 Sexual side effects, as listed9. REAÇÕES ADVERSAS · Distúrbios do sistema reprodutivo e mamas · Incomum ≥1/1000 a <1/100 The same text also says9. REAÇÕES ADVERSAS This is the holder's own copy. The regulator's database refused our requests (it blocks by country; we asked from Denmark). A table cell or list line is shown whole, as the text prints it. Some of them also name side effects that are not sexual. | Text for professionals PRISTIQ succinato de desvenlafaxina monoidratado: bula para o profissional de saúdePristiq comprimidos revestidos de liberação prolongada 50 mg e 100 mg, Pfizer Brasil Ltda. · Read on the holder's own site: Pfizer Brasil Ltda.Also on record: patients' leaflet, with such a sentence | Text approvedChecked |
| India | Sexual side effects, as listedUndesirable Effects Sexual side effects, as listedUndesirable Effects This text has no sentence about sexual side effects continuing after the medicine is stopped. This is the holder's own copy. This regulator publishes no database of such texts. The originator product's text could not be opened. This is the text of another product, the one named in this row. A table cell or list line is shown whole, as the text prints it. Some of them also name side effects that are not sexual. | Text for professionals D-VENLOR TabletsD-VENLOR film-coated extended-release tablets, Cipla Ltd. · Read on the holder's own site: Cipla (ciplamed.com) | Text revisedChecked |
Brand names
These are the brand names of desvenlafaxine we saw in the official lists, compendia and regulators' pages we opened on or after 20 October 2026. A country may have more.
- Pristiq
- United States, Canada, Spain, Brazil
- Faxilex
- Italy
- Exital
- Spain
- Afax
- Brazil
- Andes
- Brazil
- Aviv
- Brazil
- Deller
- Brazil
- Desdiff
- Brazil
- Desduo
- Brazil
- Desenvo
- Brazil
- Destyc
- Brazil
- Desve
- Brazil
- Desventag
- Brazil
- Elifore
- Brazil
- Imense
- Brazil
- Rytmise
- Brazil
- Vellana
- Brazil
- Vendexla
- Brazil
- Venlapress
- Brazil
- Vyxara
- Brazil
- Zodel
- Brazil
What is not known
- No reliable figure exists for how often PSSD happens. (source)
- One study of health records gives an estimate for men, counted through prescriptions for erection medicines. (source)
- It is not known how many people fully recover. (source)
- None of the product texts we read says how long the sexual dysfunction can last. (source)
Code and reporting
In a report to a medicines regulator, the term is Post-SSRI sexual dysfunction (MedDRA code 10086208). Where to report, country by country
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