UK antidepressant leaflets: the new wording

Read the leaflet in a UK antidepressant pack recently? The part on sexual side effects is about to change. On 15 October 2026 the MHRA, the UK medicines regulator, said leaflets for ten antidepressants will name post-SSRI sexual dysfunction (PSSD), sexual problems that can continue after stopping.

The new paragraph says “Rarely people can experience more persistent sexual side-effects”. Three sentences later, it says research is needed to understand “how common it is”.

Most leaflets still carry the old wording. In this BBC News film from 2023, side effects from the sertraline and citalopram leaflets are read out from 3:04, and Connor describes what happened to him from 5:40.

Play video: Antidepressants: Should we talk about side-effects? - BBC News

The full new text is public already, even if your pack doesn’t have it yet.

What will the new antidepressant leaflet say?

It keeps the opening sentence, more or less, and replaces the one after it. The MHRA has published the text. Each leaflet fills in its own medicine’s name:

“Medicines like [medicines name] may cause symptoms of sexual dysfunction. Rarely people can experience more persistent sexual side-effects after they have stopped taking SSRIs. The term ‘post SSRI sexual dysfunction’ (PSSD) has been used by some people to describe these symptoms. For these people, PSSD can have a significant and distressing impact on their lives. Research is needed to understand why this happens and how common it is. It is important that people experiencing ongoing sexual side-effects receive appropriate and timely support.”

Since 2019 the leaflets have said one short thing instead: “In some cases, these symptoms have continued after stopping treatment.” The new text names the condition, which the 2019 update didn’t. It also says PSSD can have a “significant and distressing” impact.

Patients had asked for the term PSSD to be named, the MHRA says.

The new paragraph talks about sexual side effects only. PSSD is more than that. Criteria proposed in 2022 also describe emotional numbing and problems with cognition, and patients told the MHRA’s advisers about non-sexual symptoms too.

Which antidepressants will mention PSSD?

Ten, the MHRA’s safety notice says: citalopram, escitalopram, duloxetine, fluvoxamine, fluoxetine, paroxetine, sertraline, venlafaxine, amitriptyline and nortriptyline.

The first eight already carry the 2019 sentence. Amitriptyline and nortriptyline are new to the list. The MHRA’s advisers added them after reviewing Yellow Card reports, the reports patients and health professionals send in about side effects. Amitriptyline isn’t an SSRI, but its new leaflet still says “after they have stopped taking SSRIs”.

Mirtazapine and vortioxetine aren’t on the list. On 2 November 2026 the government told Parliament that the MHRA keeps sexual side effects of both “under close monitoring”.

The same update brings other safety measures, which the MHRA says are for all patients. Leaflets get a boxed warning about suicidal thoughts, and a patient card is being introduced. A separate safety leaflet, to be handed out by doctors, is due in 2027. If you’re struggling, call Samaritans on 116 123.

Does my leaflet have the new PSSD wording yet?

Probably not yet. On 6 November 2026 we opened the first ten leaflets in the search results of the Electronic Medicines Compendium, the UK’s online library of leaflets, for each of six medicines. Only three carried the new paragraph: one maker’s amitriptyline 10 mg, 25 mg and 50 mg tablets, revised in October 2026.

Every sertraline, escitalopram, citalopram, fluoxetine and venlafaxine leaflet we opened still had the 2019 sentence. That includes the brand leaflets for Lustral, Cipralex, Cipramil and Efexor XL. The other amitriptyline leaflets had no warning about problems continuing after stopping.

The MHRA says the updated leaflets “will start to appear in the medicine boxes within the next 6 months”, in its report of 15 October 2026. It says online versions will come sooner.

The leaflet in your pack may be older than the one online. To check, look for the line near the end that says when it was last revised.

What can I do if I think I have PSSD?

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

If you think you have PSSD, bring your leaflet to your GP and point to the line. Many people say it took time to be taken seriously. You can report it without a doctor agreeing.

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

What else do people ask?

Why does the new leaflet say “rarely”? The MHRA’s advisers based the wording on text from the Royal College of Psychiatrists. Nobody has measured how often PSSD happens. The MHRA’s own review found that evidence on the size of the risk “remains limited”.

Will my GP bring it up? The MHRA has asked them to. Its notice tells doctors to say, when starting an antidepressant or changing the dose, or at the next review, that symptoms “may continue after stopping”. They’re also told to mention that “some patients refer to this as ‘PSSD’”. Our page on what regulators say about PSSD has more.

Does this mean PSSD is officially recognised? It will be named on the leaflets, and it has its own term in the dictionary regulators use for side effects. The MHRA notes it currently has no code in the main disease classification. For how the NHS website covers sexual side effects, see what the NHS says.

If the next leaflet you get has the new paragraph, keep it. It names PSSD in words the regulator approved.

Sources

1. MHRA, Antidepressants: new safety measures for all patients to improve communication of the risk of suicidal thoughts and behaviours and persistent sexual dysfunction, Drug Safety Update volume 20, issue 3, 15 October 2026. Read 6 November 2026. “The term “Post SSRI Sexual Dysfunction” (“PSSD”) will be added to the PILs of antidepressants associated with a risk of sexual dysfunction that may continue even after the drug is stopped.” Footnote 1 lists the ten medicines. Advice to doctors: discuss “that symptoms may continue after stopping treatment with certain antidepressants. Some patients refer to this as “PSSD"". The safety (ancillary) leaflet “will become available in 2027”.
2. MHRA, Antidepressants: use and safety, updated 15 October 2026. Read 6 November 2026. Section 3 gives the new leaflet text quoted above. It notes there is “currently no International Classification of Disease (ICD) code for PSSD”. “In addition to sexual symptoms patients also reported non-sexual symptoms.” Patients said the term “should be specifically mentioned”.
3. MHRA, Antidepressants: updated safety communications, Public Assessment Report, 15 October 2026. Read 6 November 2026. Table 1 sets the current section 2 warning (“In some cases, these symptoms have continued after stopping treatment.”) beside the new one. The wording reflects “that published by the Royal College of Psychiatrists”. Amitriptyline and nortriptyline were added “based on the review of Yellow Card data”. “Evidence on the magnitude of the risk remains limited”. Next steps: updated PILs “will start to appear in the medicine boxes within the next 6 months. The electronic versions of PILs will be available sooner.”
4. MHRA, Patient and family experiences inform antidepressant safety information review, news story, 1 December 2025. Read 6 November 2026. The review covered 28 antidepressants. The Commission on Human Medicines “recommended updates to the PILs for certain antidepressants to better reflect patient feedback and emerging evidence”.
5. UK Parliament, written question HL4193, asked by Lord Alton of Liverpool on 19 October 2026, answered by Baroness Merron on 2 November 2026. Read 6 November 2026. “The risk of sexual dysfunction associated with antidepressants, including mirtazapine and vortioxetine, remains under close monitoring”.
6. UK patient leaflets on the Electronic Medicines Compendium, all opened 6 November 2026. With the new paragraph: Brown & Burk amitriptyline 10 mg, 25 mg and 50 mg film-coated tablets. Each was last revised 10/2026 and updated on the EMC on 29 October 2026.
7. Still carrying only the 2019 sentence, with the leaflet’s last-revised date: Lustral 50 mg and 100 mg (sertraline), 12/2025; Cipralex 10 mg (escitalopram), 05/2025; Cipramil 20 mg (citalopram), 01/2025; Efexor XL 75 mg (venlafaxine), 10/2025; fluoxetine 20 mg capsules, PL 25298/0301, 09/2022. The full list of 60 leaflets checked is in our evidence record.
8. 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. Ancillary non-sexual symptoms “may include” “emotional numbing” and “cognitive impairment”.
9. UK Parliament, written question HL11843, answered 25 November 2025. Read 6 November 2026. The PSSD term was added to MedDRA in version 24.1 and to the Yellow Card website in February 2022.
10. Video: BBC News, Antidepressants: Should we talk about side-effects?, August 2023.

Sources checked on 6 November 2026. AI-assisted writing and review, not clinical review.