Which antidepressants are linked to PSSD?
The warning about persistent sexual dysfunction was added to every SSRI and SNRI, not to one drug. Here is the full list, and what we cannot tell you.
SSRIs and SNRIs carry a warning about sexual side effects that continue after the drug is stopped. European regulators added it in 2019, and they added it to the whole class rather than to any single drug. Every medicine listed below carries it, from sertraline to venlafaxine.
The drugs
The class change is documented by Healy and Mangin, 2024. The medicines in each class are those the NHS lists.
- SSRIs
- Sertraline (Zoloft, Lustral) · Citalopram (Celexa, Cipramil) · Escitalopram (Lexapro, Cipralex) · Fluoxetine (Prozac) · Paroxetine (Paxil, Seroxat) · Fluvoxamine (Faverin, Luvox)
- SNRIs
- Venlafaxine (Effexor, Efexor) · Duloxetine (Cymbalta, Yentreve) · Desvenlafaxine (Pristiq)
Being on the list does not mean a drug will do this to you. It means the regulator judged the risk real enough to print on the box.
Two other drugs cause the same syndrome
PSSD is not only an antidepressant problem, and this is the part most people have never been told.
- Finasteride, dutasteride
- Propecia, Proscar, Avodart. Post-finasteride syndrome (PFS)
- Isotretinoin
- Roaccutane, Accutane. Post-retinoid sexual dysfunction
The 2022 diagnostic criteria cover all three together, because the symptoms after each are close enough that one set of criteria describes them. A 2026 review notes one possible reason: both antidepressants and finasteride may affect 5-alpha-reductase, the enzyme that produces the neurosteroid allopregnanolone.
What we cannot tell you
We are a patient charity, not clinicians. We cannot tell you which antidepressant to take, whether yours is a good choice, or what to do about the one you are on. That is not modesty, it is the limit of what we are for.
We also cannot tell you your odds, and neither can anybody else. Published estimates run from 0.46% to 52.6%. Healy and Mangin give four reasons for that gap:
- The trial that would settle it would be unethical to run.
- There is no agreed way to measure the condition.
- People are embarrassed, or are dismissed when they raise it.
- Even when a doctor is told, the note is not recorded where anyone counting cases can find it.
None of those reasons is that the symptoms are hard to see.
Anyone who quotes you a single percentage for this is going past what has been published.
Do not stop an antidepressant because of anything on this page.
Stopping suddenly can cause severe withdrawal effects, and for some people the underlying condition returns. Any change belongs in a conversation with the person who prescribed it. If sexual side effects are your concern, that is a reasonable thing to raise at that appointment.
What we can tell you
That the warning exists, on which drugs, and where it came from. That symptoms can start while taking a drug and continue, or only appear after stopping, according to the diagnostic criteria. And that if it has happened to you, there is a specific term regulators can file it under.
MedDRA code 10086208
English term: Post-SSRI sexual dysfunction
Use it if you took an SSRI or SNRI. If you took finasteride or dutasteride the term is Post 5-alpha-reductase inhibitor syndrome, code 10082430. Write the exact wording in the free-text box, then describe your symptoms in your own words. Our reporting guide covers 65 countries.
A psychiatrist explaining it
Dr Josef, a psychiatrist, on PSSD and why it so rarely comes up in an appointment. Nine minutes.
Taper Clinic is an independent service and not connected to us. We link the explanation, not the business.
Before you start one
If you are deciding whether to begin an antidepressant, the useful question is not which is safest. It is whether you were told this risk exists at all.
Ask your prescriber what they know about sexual side effects continuing after the drug is stopped, and whether they have seen it. The label they are prescribing from says it can happen.
If you are struggling with your mental health, the Samaritans are on 116 123, free, at any hour.