Can PSSD happen after a few pills?
Most reports of PSSD follow months on an antidepressant. Some describe it after a few days of tablets, lasting after stopping. Nobody knows how often.
SIDEfxHUB is a patient charity. We are not health professionals, and this does not replace medical advice. Don't start, stop or change any medicine because of what you read here. Talk to your doctor first.
If you are in crisis:116 123 Samaritans (UK)988 Lifeline (US)Find a helpline
Post-SSRI sexual dysfunction (PSSD) has been reported after a few days of an antidepressant, with sexual problems that continued after stopping. Most reports follow months or years of use, but the doctors and researchers who wrote the diagnostic criteria say several days may be enough.
Nobody has measured how often that happens, so nobody can give you odds. If you’ve taken a few tablets and something feels different, tell your prescriber before you change anything, and write down your dates.
The story in 3 lines
- The UK sertraline leaflet says sexual problems have in some cases “continued after stopping treatment”. It doesn't say how long you'd have to take it.
- The 2022 criteria for diagnosing PSSD say it “may be triggered by exposures as brief as several days” (criteria).
- In reports to the Dutch drug-safety centre, the shortest course was nine days (its report). Nobody has counted how often PSSD follows a short one.
Press: contact@sidefxhub.com
Anthony had never taken a psychiatric medicine. After a couple of months of poor sleep, a psychiatrist prescribed him 25 mg of sertraline.
He took 11 tablets. Since the last one, he says, he’s had “persistent genital numbness”, and his sex drive has gone. “I never believed that this could happen with just 11 pills.”
Can one SSRI tablet affect sex?
It can, and quickly, say the authors of the 2022 criteria. Nearly everyone who takes an SSRI, they write, gets some change in how their genitals feel within an hour of the first dose. Not everybody notices it.
That early change is a side effect. On its own, it isn’t PSSD. Sexual side effects usually last as long as the medicine is taken and go once it stops, says a 2026 paper by New Zealand’s medicines regulator.
Can one tablet lead to PSSD? The research barely says. In reports to RxISK, a website where people report side effects, the shortest course was a single dose.
Those reports cover two other kinds of medicine as well, and the paper doesn’t say which one that dose was. Nothing else we read describes a case after one tablet, and nobody has measured how often it happens.
The NHS page on sertraline says most side effects should ease after a couple of weeks. It doesn’t mention that sexual ones can carry on after the last tablet. The leaflet in the pack does.
Anthony’s whole course lasted less than two weeks.
Anthony's 11 tablets
Can PSSD start after a few days or weeks?
Some reports say it can. Fifteen people who told RxISK about lasting sexual problems said they’d taken their antidepressant for less than two weeks.
In 2007, doctors at a Texas medical school described a woman who felt “totally numb” in her genitals within days of starting citalopram. She took it for four weeks and was then switched to a different antidepressant. More than a year after she’d stopped all treatment, the numbness was still there.
Max took sertraline for about a month in 2018. “My life has completely changed,” he says.
Music and food stopped giving him pleasure, he says. He was later given other antidepressants. When he was filmed, he said he had almost no sex drive and his genitals were numb, and that nothing had changed in five years.
Is a short course less risky?
Nobody knows. Most reports do follow longer use.
When the Dutch drug-safety centre went through its reports of lasting sexual problems after an SSRI, most people had taken it for a few months to two years. The shortest course was nine days.
Like the RxISK ones, those are reports that people chose to send in, so they can’t show whether a short course is safer. A 2023 review of the research couldn’t find a reliable figure for how often PSSD happens at all. Its authors asked for research into whether the amount someone has taken makes a difference.
For some people it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.
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.
Tell your prescriber what changed and when, however short the course: “Sertraline 50 mg, six tablets from 3 March 2026. Numb to touch since 6 March.”
You don’t need to wait for your next appointment. In England, adults newly prescribed an antidepressant for depression can also talk it through with a pharmacist, free.
If you and your prescriber do stop it, the 2022 criteria say ordinary sexual side effects can linger for days or weeks after the last tablet. After three months, they say, PSSD is more likely. Our article on a sex drive that doesn’t come back explains the wait.
Many people say it took time to be taken seriously. Bring the leaflet line, which for sertraline reads: “In some cases, these symptoms have continued after stopping treatment.” You can report it without a doctor agreeing.
Dr Josef Witt-Doerring, a psychiatrist, recorded this film for patients to show their own doctor.
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).
Our reporting guide walks you through it
If you’re struggling with your mental health, Samaritans are free on 116 123, at any hour.
What else do people ask?
Sex felt different on the first tablets. Is that PSSD? Not on its own. The 2022 criteria for PSSD need a change in genital sensation that’s still there after stopping, with no other cause. Our article on PSSD or depression goes through the other causes.
Can it start after I’ve stopped? It can. The 2022 criteria say a lasting problem sometimes only appears once the medicine is stopped, or a mild one gets worse. Where there’s a gap between the last dose and the first sign, they add, it’s typically up to a couple of weeks.
Does it matter which antidepressant it was? In 2019 the EU medicines regulator asked for a warning on every SSRI and SNRI. The UK sertraline leaflet carries it. Our list of the antidepressants linked to PSSD names all ten.
Anthony kept his texts with his psychiatrist and his family, and used them to work out his dates. If a few tablets changed something for you, write your dates down today and report it.
Sources
- Lustral (sertraline) 50 mg and 100 mg film-coated tablets, patient leaflet, Viatris, electronic medicines compendium (emc 2835), last revised December 2025. Section 2, “Sexual problems”: “In some cases, these symptoms have continued after stopping treatment.” The line gives no length of use. Section 3: “Do not stop taking Lustral unless your doctor tells you to.”
- 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. Section 3: “The condition may be triggered by exposures as brief as several days”; “Close to all people taking an SRI have some alteration of genital sensitivity within an hour of starting treatment”, which may or may not be noticeable.
- The same paper, sections 3 and 9. Ordinary sexual side effects may linger for “some days or weeks” after stopping; after three months PSSD is more likely. A lasting problem may only appear on stopping, with a delay of “typically up to a couple of weeks”.
- Netherlands Pharmacovigilance Centre Lareb, SSRIs and persistent sexual dysfunction, quarterly report, 26 October 2012. Nineteen reports up to 22 February 2012, 15 of them from patients. Duration of treatment “a few months to two years in most cases (range 9 days – 10 years)”. Spontaneous reports, with no comparison group.
- 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 to RxISK.org. Length of treatment was known for 226 reports and ran “from a single dose to over 16 years”; the paper covers three kinds of medicine and does not say which one the single dose was. Nineteen people reported less than two weeks of treatment, 15 of them on a serotonin reuptake inhibitor. Self-selected reports, with no comparison group.
- Kauffman RP, Murdock A. Prolonged post-treatment genital anesthesia and sexual dysfunction following discontinuation of citalopram and the atypical antidepressant nefazodone. The Open Women’s Health Journal 2007;1:1-3. One woman, aged 32: citalopram 20 mg for four weeks, then nefazodone for 14 months. The authors, at Texas Tech University Health Sciences Center, write that her symptoms may be down to citalopram alone.
- Medsafe, Update on sexual dysfunction following discontinuation of serotonin reuptake inhibitors, paper for the Medicines Adverse Reactions Committee, 11 June 2026. Section 2.2: sexual side effects “usually persist for as long as the medicine is taken and resolve after discontinuation”.
- NHS, Sertraline, page last reviewed 8 September 2025. It says most side effects “should ease after a couple of weeks as your body gets used to the medicine, but some can last longer”. The New Medicine Service page, last reviewed 17 November 2023, covers people in England aged 18 or over who are newly prescribed a medicine for depression.
- 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 prevalence; the authors call for research into a dose-response relationship.
- European Medicines Agency, PRAC recommendations on signals adopted at the 13-16 May 2019 PRAC meeting, section 1.3, adopted 16 May 2019. It names six SSRIs and four SNRIs and gives the leaflet wording: “In some cases, these symptoms have continued after stopping treatment.” Of the UK leaflets, we opened the sertraline one (source 1) for this article.
- Moral Medicine, interview with Anthony, 20 October 2025. No earlier psychiatric medicine and the poor sleep at 3:31, 25 mg at 4:18, the lunch after a funeral at 6:35, his saved texts at 7:17, the tingling on 29 April at 7:40. His psychiatrist’s reply at 8:10, 11 tablets from 19 April to 1 May and “persistent genital numbness” at 8:20, no libido at 10:47, “just 11 pills” at 19:45. His story on our site: Anthony’s story: 11 pills of sertraline.
- Moral Medicine, interview with Max, 11 February 2026, embedded here as an extract from 1:10 to 3:20. About one month of sertraline in 2018 at 1:20, “My life has completely changed” at 1:52, music and food at 2:30, five years with nothing changed at 7:10, the later medicines at 8:00, libido and genital numbness at 12:10. His story on our site: Max’s story: 1 month on sertraline.
- Dr Josef Witt-Doerring, PSSD (An Explanation For Doctors), 27 May 2024.
- MedDRA lowest level term Post-SSRI sexual dysfunction, code 10086208.
This information does not replace medical advice. Talk to your doctor before you make any decision about your treatment.
590+ people have joined the community.
Join them, then report your side effects.
No diagnosis needed. Researchers never see your name.