Post-SSRI Sexual Dysfunction

They stopped the antidepressant. The side effects stayed.

  • Sex, feeling, memory and sleep can all go numb.
  • It happens with SSRIs and SNRIs. Thousands of people report it.
  • No ICD code. No treatment. Only partly recognised.
What is not widely known

In 2019 the EMA agreed: the sexual side effects can last after you stop.EMA PRAC, 2019

32 years passed from the first reports to official recognition.Regulatory record

Over 60 million prescriptions a year. Almost no doctor is taught this exists.Prescribing data

PSSD has no ICD code of its own, so nobody counts the cases.ICD-10 F52.8

What is PSSD?

PSSD is when the side effects of an antidepressant do not go away after you stop taking it. Sex, feeling and thinking can all be affected. It can last weeks, months or years.

Nobody knows yet why it does not go away. One idea is that the drug changes how genes switch on and off.

The EMA recognised PSSD in 2019, and drug labels across Europe had to change. Most doctors who prescribe these drugs still do not know. There is no test and no approved treatment.

Symptoms

Symptoms that do not go away

They can start while you take the drug, or after you stop.

Sexual

5
  • Numb genitals, or much less feeling
  • No sex drive at all
  • Trouble getting an erection
  • Orgasms feel weak, or feel like nothing
  • Vaginal dryness

Mind and feelings

5
  • Emotional blunting (feelings go flat)
  • Anhedonia (you cannot feel pleasure)
  • Feeling unreal, or cut off from yourself
  • Brain fog and memory problems
  • Broken sleep, or no sleep

Physical

3
  • Tiredness that does not go away
  • Less feeling in the skin
  • Weak muscles

This is not the full list. These are the symptoms people report most often.

The Numbers

PSSD by the numbers

135M+ US SSRI prescriptions a year ClinCalc DrugStats, 2024 - prescriptions, not people
31 years From the first SSRI to a regulator accepting that these effects can last Fluoxetine approved Dec 1987 · EMA PRAC, May 2019
14.2x Odds of lasting genital numbness in past antidepressant users, compared with other medicines Pirani et al. 2024, adjusted - 95% CI 2.9-257, ages 15-29. A wide range, and not only SSRIs.
Timeline

It took 32 years to be recognised

1987

The FDA approves Prozac

Trials report sexual side effects in 2-16% of people. The maker is later accused of reporting too few cases.

2012

GSK $3 billion settlement

GlaxoSmithKline pays the biggest healthcare fraud settlement in US history. It was partly about Study 329 and selling Paxil (paroxetine) to children.

2019

The EMA recognises PSSD

The European Medicines Agency accepts that the sexual side effects can last after you stop. Labels change across Europe.

2021

A MedDRA code exists, but it is buried

MedDRA adds the term “Post-SSRI sexual dysfunction” (code 10086208). But it sits under the wider term “Sexual dysfunction”, so reports get mixed into a general group. Regulators still do not count PSSD on its own.

2025

The FDA turns down a petition

Public Citizen asks the FDA for stronger warnings. The FDA says no. US patients are left without that protection.

Key Research

What the research says

Patients and independent researchers pay for this work. No drug company has publicly funded any of it.

Healy et al.

PSSD is a condition of its own. Sex, feelings and thinking are all affected, and it lasts.

Giatti et al. (2025)

In animals, paroxetine caused lasting changes to dopamine, a brain chemical.

Csoka & Szyf (2009)

SSRIs may change how genes switch on and off, and the change can last after the drug stops.

Rice et al. (2025)

Patients described what it did to their lives, and how hard it was to be believed.

The Drugs

The drugs involved

This is a whole drug class, not one drug. Paroxetine is named most often.

Paroxetine Highest reported risk Paxil, Seroxat · SSRI Named most often in PSSD reports. GSK paid $3 billion in 2012 over how it was sold (US Department of Justice). Study 329 found it did not work in teenagers.
Sertraline Zoloft · SSRI One of the most prescribed SSRIs. Reported: genital numbness, emotional numbness.
Fluoxetine Prozac · SSRI The first SSRI, approved in 1987. Trials showed sexual side effects in 2-16% of people.
Escitalopram Lexapro, Cipralex · SSRI Marketed as having fewer side effects. Reported: no sex drive, no orgasm.
Citalopram Celexa · SSRI
Venlafaxine Effexor · SNRI Known for a hard withdrawal, and for sexual side effects that last.
Duloxetine Cymbalta · SNRI Also given for long-term pain, not only depression and anxiety.
Desvenlafaxine Pristiq · SNRI The active part of venlafaxine, sold as its own drug.
Vortioxetine Trintellix, Brintellix · other serotonin drug Not an SSRI or SNRI, but it works on serotonin too.
Paroxetine mesylate Brisdelle · SSRI, not for mental health The same drug at a lower dose, sold for hot flushes in menopause.

This is not the full list. These are the drugs reported most often. Any medicine that works on serotonin may carry the same risk, including ones given for other reasons.

The Reporting Gap

Most cases never reach the data

Very few PSSD cases are ever reported. So the official numbers are far too low.

Ever reaches a regulator1–10%
Never reportedmost of the rest
1–10% of drug side effects are ever reported. The FDA’s own estimate.

No dedicated ICD code

PSSD has no ICD code (the code a health system files an illness under). Orphanet maps it only to F52.8, a general “other sexual dysfunction” box, so no system counts it.

Patients do not make the connection

Many people are never told that an SSRI can do this. When it does not stop, they blame age, stress or their depression.

Doctors dismiss reports

Many doctors say it is the depression, not the drug. So the report is never made.

Under-reporting shapes the evidence itself

What gets reported becomes the evidence. A side effect that is rarely reported looks rarer than it is, so report it.

I think I have PSSD. What now?

If you recognise these symptoms, here are 5 steps you can take right now.

1

You are not imagining this

The EMA recognises PSSD, and it is in the research. Thousands of people have the same symptoms.

2

Connect with others

Join a WhatsApp support group and talk to people who know what this is like.

3

Report your side effects

Report it to your country's health regulator. Every report makes this harder to ignore.

4

Read about living with it

Our Support Library has guides on coping, talking to your doctor, and daily life.

5

Join the registry

Register your experience anonymously. Your data helps research, and helps show how many people this hits.

PSSD patient registry

Help build the evidence base

Every entry is a data point researchers and regulators can act on. That is what won PSSD its EMA recognition in 2019. It takes about 3 minutes, and you can stay anonymous.

If you are in crisis: 116 123 Samaritans (UK) 988 Lifeline (US) Find a helpline