Background for journalists and doctors
PFS, PSSD and PAS: conditions caused by finasteride, SSRIs and isotretinoin. Every fact here has a source you can check.
Background briefing
Six starting points, each with its source.
What the conditions are
PFS follows finasteride. PSSD follows SSRIs. PAS follows isotretinoin. All three can affect sexual function, mood and cognition, and can start or continue after the drug is stopped. Only a small number of patients are affected. For them, symptoms can last a long time.
Source: PubMedWhat the drug regulators accepted
In 2011 the FDA made finasteride labels say sexual side effects may not go away. The EMA did the same for SSRIs and SNRIs in 2019. MedDRA codes both: “Post-SSRI sexual dysfunction” (10086208), “Post 5-alpha-reductase inhibitor syndrome” (10082430). Patients and doctors use neither name.
Source: EMA PRAC, FDA label historyNot yet taught in medical training
A 2024 Harvard Medical School survey found 18% of dermatologists (skin doctors) thought lasting effects were possible. These conditions are uncommon, and medical training does not cover them yet. Better information is what helps most here.
Source: Harvard Medical School, 2024What the biology suggests
One peer-reviewed study found 3,764 genes working differently in PFS patients. Animal studies found clear brain changes too. That is hard to explain by expectation alone.
Source: Journal of Sexual Medicine, 2021Reports on record
WHO VigiBase holds 21,287 finasteride side effect reports from 153 countries. FDA FAERS holds 11,557. A report is not proof that the drug caused it. The numbers show how much is being reported.
Source: WHO VigiBase, FDA FAERSWhy the numbers are likely low
Reporting a side effect is voluntary. The FDA estimates only 1-10% of reactions are ever reported. Nobody yet knows how many people these conditions affect.
Source: FDA pharmacovigilance guidanceKey databases & sources
FDA FAERS Dashboard
Search side effect reports for finasteride, SSRIs and isotretinoin.
Visit dashboard →PubMed: PFS research
Peer-reviewed papers on Post-Finasteride Syndrome.
Search PubMed →BMJ: the Study 329 re-analysis
An independent second look at the paroxetine trial data, under the RIAT initiative.
Read the analysis →WHO VigiBase
The global database of single case safety reports.
Visit database →Expert contacts
Researchers and advocates you can interview.
Prof. Roberto Melcangi
University of Milan. A leading PFS researcher. Studies brain hormones, gene switching and the gut-brain link.
Dr. David Healy
RxISK.org. Psychiatrist and drug safety expert. Works on how PSSD is defined and diagnosed.
PFS Foundation
The leading PFS patient group. Can put you in touch with patients who will speak on record.
Media enquiries
Email media@sidefxhub.com for interviews, data, or an introduction to patients and researchers.
SIDEfxHUB is the patient charity for people living with post-drug syndromes. Our focus is PFS, PSSD and PAS. UK Registered Charity #1203385.
590+ people have joined the community.
Join them, then report your side effects.
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