PSSD: The Hidden Truth About Antidepressants

Antidepressants, often seen as safe, can have devastating hidden risks. Post-SSRI Sexual Dysfunction (PSSD) leaves thousands with permanent sexual dysfunction, emotional numbness, and physical impairment. For many, SSRIs also drastically increase the risk of suicidal ideation, adding another layer of harm. Patients are rarely warned, while pharma companies, health agencies, and doctors dismiss these dangers. It’s time to demand transparency and action by speaking out and raising awareness.

Reported Adverse Side Effects from SSRIs

United Kingdom

30.228

USA & Canada

42.141

Scandinavia

6.713

benelux

Benelux

17.123

Sources: VigiAccess – WHO
Last updated: 19/11-2024

PSSD in the Media

PSSD Patient Stories

Hear the devastating stories from other PSSD patients. Watch more videos on Moral Medicine YouTube channel.

Post-SSRI Sexual Dysfunction (PSSD) is a rare, persistent condition that can develop after discontinuing selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Symptoms include reduced libido, genital numbness, anhedonia, erectile dysfunction, and other sexual or emotional impairments, lasting months or years post-treatment. The exact cause is unknown, but it may involve changes in serotonin signaling or nerve function. PSSD significantly impacts quality of life and often lacks recognition in mainstream medical practice.

Post-SSRI Sexual Dysfunction (PSSD) is a serious condition that occurs after the use of antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs). PSSD is characterized by lingering sexual, physical, and emotional symptoms that persist even after stopping the medication. For many who suffer from it, PSSD disrupts their quality of life, leaving them feeling confused and isolated.

Many individuals with PSSD report feeling that their condition is overlooked by healthcare providers, who often dismiss the connection between the medication and their ongoing symptoms. The uncertainty surrounding PSSD can be overwhelming, but there is a growing community offering support and resources to those affected.

PSSD symptoms can vary widely from person to person. While sexual dysfunction is the most commonly reported issue, there are a range of physical and emotional effects. Some of the common symptoms include:

Sexual Symptoms:

  • Decreased libido
  • Erectile dysfunction
  • Anorgasmia
  • Genital numbness
  • Decreased lubrication

Emotional Symptoms:

  • Emotional blunting / anhedonia
  • Depression
  • Anxiety

Physical Symptoms:

  • Muscle atrophy
  • Fatigue
  • Skin issues
  • Digestive issues
  • Accelerated aging
  • Neuropathy
  • Akathisia
  • Weight changes

It’s important to note that these symptoms can persist for years after discontinuing the antidepressant, with many individuals reporting permanent effects. Diagnosing PSSD can be challenging, as there are no specific tests, and symptoms often overlap with other conditions. Diagnosis typically involves ruling out other causes and reviewing the patient’s medication history.

PSSD is more than a medical condition; it is a deeply disruptive experience that affects nearly every aspect of life. Surveys reveal that 59% of individuals with PSSD describe its impact on their quality of life as extremely negative, while 23% report it as very negative.

Emotional and Psychological Effects
PSSD can lead to intense emotional distress, leaving sufferers feeling:

  • Depressed, unable to find joy or motivation.
  • Angry, frustrated with medical providers or medications.
  • Socially Isolated, withdrawing due to shame or discomfort.
  • Low in Self-Esteem, doubting their worth or attractiveness.
  • Disconnected from Gender Identity, feeling less masculine or feminine.

Strained Relationships
PSSD affects romantic relationships, often causing avoidance of intimacy due to self-esteem struggles. This can lead to trust issues, hostility, and emotional distance. Partners may feel rejected or undesirable, creating further strain.

Broader Social and Professional Consequences
The stigma of PSSD can result in social withdrawal and reduced workplace productivity, as emotional stress takes its toll.

Partners’ Perspective
Partners often experience anxiety, feelings of rejection, and even suspicion. Open communication and professional support are essential to navigating these challenges and rebuilding connection.

All SSRIs and SNRIs carry a risk of causing PSSD, so it’s essential to look online for others’ experiences with specific types of these medications. Here is a list of the most commonly prescribed SSRIs (Selective Serotonin Reuptake Inhibitors) that are known  to cause PSSD:

  • Fluoxetine (brand names: Prozac, Sarafem)
  • Sertraline (brand name: Zoloft)
  • Paroxetine (brand names: Paxil, Seroxat, Pexeva, Brisdelle)
  • Citalopram (brand name: Celexa)
  • Escitalopram (brand names: Lexapro, Cipralex)
  • Fluvoxamine (brand names: Luvox, Faverin)

There are many other types of SSRIs and SNRIs that can lead to PSSD.

Do you already suffer with PSSD? Join our PSSD WhatsApp groups for support, connection, and valuable information: Join us on WhatsApp.

The exact cause of PSSD remains unclear, but several biological theories exist. One popular theory suggests that PSSD may result from changes in the 5-HT1a receptor, which influences serotonin levels. Other potential explanations include altered neurotransmitter function, disruptions in testosterone and estrogen regulation, or epigenetic changes that affect how genes are expressed.

The complexity of PSSD, combined with the ongoing psychological distress many patients experience, makes it difficult to pinpoint a single cause. However, recognizing that PSSD is real and can occur is an important step towards addressing its impact on those who suffer from it.

For more detailed insights into managing symptoms, you can explore our articles on Exercise and Diet: Cautious Steps Towards Managing PSSD and Coping with Social Isolation After a PSSD Crash.

Currently, there is no definitive cure for PSSD. Treatment typically focuses on managing symptoms through a combination of psychological counselling, lifestyle changes, and sometimes medications that aim to alleviate specific symptoms.

Some patients have found relief through:

  • Bupropion or buspirone: These medications have been used with varying degrees of success to address sexual dysfunction.
  • Viagra or Cialis: For those struggling with erectile dysfunction, these medications may help improve sexual performance.
  • Non-serotonergic antidepressants: Medications like bupropion or vilazodone are sometimes used as alternatives with lower risks of sexual side effects.
  • Therapy and support groups: Engaging in therapy and joining online communities can offer emotional support and practical advice for managing PSSD.

If you’re looking for practical advice on living with PSSD, consider our resources on Managing Sleep Issues After a PSSD Crash and Finding Support: Connecting with the PSSD Community.

If you think you may have PSSD, take a proactive step and learn more about what to do next by reading our article: I Think I Have PSSD, What Should I Do?

Dealing with PSSD can be an isolating experience, but it doesn’t have to be. There are active communities of individuals who understand what you’re going through. Whether you’re looking for advice, comfort, or shared experiences, our WhatsApp groups offer a safe space to connect with others.

Join the conversation by joining our WhatsApp groups to find support and discuss strategies for managing life with PSSD.

david healy pssd

David Healy

Professor of Psychiatry in McMaster University Canada

“At present, neither the companies that make SSRIs nor academic researchers are looking at PSSD, which, if we include those unable to get off the drugs, likely affects millions. All of the research for these and other drug hazards is increasingly done by those affected.”

Dr. Mark Horowitz

MBBS PhD
Academic psychiatrist in training
on how to taper off psychiatric medications

“I received 300 emails asking for help coming off antidepressants since the BBC documentary, most have had withdrawal symptoms misdiagnosed as relapse by their doctors. The most interesting were a handful of psychiatrists who wanted help to come off their own drug.”

Dr. Mark Horowitz

MBBS PhD
Academic psychiatrist in training
on how to taper off psychiatric medications

“I received 300 emails asking for help coming off antidepressants since the BBC documentary, most have had withdrawal symptoms misdiagnosed as relapse by their doctors. The most interesting were a handful of psychiatrists who wanted help to come off their own drug.”

google trends pssd

Source: Google Trends

The Growing Awareness of PSSD

Post-SSRI Sexual Dysfunction (PSSD) has rapidly gained attention online, with increasing numbers of individuals sharing their experiences across forums, social media, and support groups. The condition, often triggered by antidepressant use, has sparked widespread concern and curiosity. As a result, search trends on Google show a dramatic rise in queries about PSSD, reflecting growing public awareness and the demand for more research. This surge underscores the urgent need for scientific investigation into its causes and potential treatments.

pfs pssd research

Research on SSRIs & PSSD

A recent study investigated the prevalence of persistent post-treatment genital hypoesthesia (PPTGH), a key symptom of post-SSRI sexual dysfunction (PSSD), among young people in the US and Canada. Results showed 13.2% of past antidepressant users experienced PPTGH compared to just 0.9% using other medications, highlighting a significant risk. The study urges standardized warnings and improved informed consent processes to prevent harm and ensure patients are aware of potential long-term effects. Further research is recommended.

Read full article here

Post-Finasteride Syndrome (PFS) and Post-SSRI Sexual Dysfunction (PSSD) are persistent, poorly understood conditions in which individuals experience enduring sexual, psychological, and neurological side effects even after discontinuing the medications. Both conditions may share underlying mechanisms involving neuroactive steroids, neurotransmitters, and gut microbiota within the gut-brain axis. The overlap in symptoms—such as sexual dysfunction, emotional numbness, and cognitive impairments—highlights the need for further research to identify diagnostic markers and effective treatments, ensuring better care for affected individuals.

Read full article here

A systematic review by Moncrieff et al. (2023) challenges the serotonin hypothesis of depression, which posits that depression is caused by lowered serotonin activity. The analysis of 17 studies, including meta-analyses and genetic research, found no consistent evidence linking serotonin levels, transporter activity, or related genetic factors to depression. Tryptophan depletion studies showed minimal effects, and long-term antidepressant use may reduce serotonin concentrations. These findings undermine the serotonin hypothesis and highlight the need for alternative explanations of depression.

Read full article here

A meta-analysis of 372 trials (99,231 adults) found antidepressant-related suicidality risk varies by age. Adults under 25 face increased risk of suicidal behaviour (OR 2.30) and ideation (OR 1.62), similar to children. For ages 25–64, effects are neutral or slightly protective (OR 0.87, 0.79). In adults 65 and older, risk is significantly reduced (OR 0.06, 0.37). These findings underscore the importance of age in assessing antidepressant safety.

Read full article here

A systematic review by Davies and Read (2019) reveals that antidepressant withdrawal is more common, severe, and prolonged than current UK and US guidelines suggest. Withdrawal affects 27–86% of users, with 46% rating symptoms as extreme. Contrary to claims that symptoms resolve within 1–2 weeks, many experience withdrawal for months or even years. The authors call for updated guidelines and better patient education to prevent misdiagnoses and unnecessary prolonged antidepressant use.

Read full article here

patient support pfs pssd

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Report your side effects here

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Journalists: Uncover the Hidden Human Cost of Antidepressants

At SIDEfxHUB, we aim to prevent more harm, give current sufferers a voice, and push for dignity and treatment solutions. We’re here to support your reporting with data, insights, and patient connections to help you create compelling, life-saving stories that resonate with your readers.

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Morten Skov
Digital & Awareness Director
SIDEfxHUB
morten@sidefxhub.com