When Antidepressants Leave Lasting Damage: Living with Post-SSRI/SNRI Sexual Dysfunction

close up of antidepressant pills
By Guest Contributor |

by Emily Grey

My clitoris is now no more than an inert and sensation-less nub of flesh. I am unable to feel attraction, arousal or orgasm.… The effects of losing my sexuality have been absolutely devastating to my relationships and mental health. I have been robbed of an essential aspect of my humanity.” – Emily, age 24, PSSD 2 years

Sexuality is an integral part of our lives, central to our identity, our quality of life, and the ways we connect with other human beings. So what happens to those of us whose sexuality is removed or severely diminished by a medication? What about when that eliminated or compromised sexuality does not recover, even after the medication is stopped? For people with long-term Post-SSRI/SNRI Sexual Dysfunction (PSSD), the impacts to our lives can be substantial.

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are classes of psychoactive pharmaceuticals used to treat depression and other mental health conditions. They come under many names and are known for causing reduced libido during treatment for many people. SSRIs are better known for this side effect than SNRIs, but both can have an impact on sexual functioning. For many users of antidepressants, the sexual side-effects are the reason they eventually discontinue the drug, with or without medical supervision.

When we patients bring our concerns about sexual functioning while on antidepressants to our health care providers, we are almost universally told that our sexuality will return to normal after tapering off the drug. Unfortunately, recent data has emerged showing that this is not always true. Some people continue to experience sexual dysfunction for weeks, months, or years after stopping the medication. Sometimes, these symptoms emerge only after tapering off the medication.

For an unfortunate minority, a total elimination of sexual drive persists indefinitely. We may have severe or total loss of erotic sensation in our genitals, sometimes to the point of tactile numbness. We may be unable to experience attraction, arousal, or orgasm – for long periods and with no other discernible cause apart from treatment with antidepressants.

In addition to the loss of libido and sexual sensation (numbness of genitalia and other erogenous zones), my general sensitivity to the pleasure of touch has declined. A caress on bare skin registers as little more than pressure…. There is a feeling of numbness, as if there is some kind of barrier between my skin and the source of contact. — Ellen, age 48, PSSD for 14 years 

Finally, some of us find our reduced sexual functioning is accompanied by emotional and cognitive symptoms such as “brain fog” or reduced emotional range, commonly referred to as “emotional blunting.” A common variant of this is the reduced or removed ability to experience emotions of romantic attachment. 

The accompanying emotional blunting … has eliminated all romantic feeling from my heart and mind…. – Emily, age 24, PSSD 2 years

The prevalence of these symptoms among patients treated with SSRIs and SNRIs is unknown, as are the underlying causes, risk factors, and recovery rates. There is currently no known effective treatment

For many years, the medical community was skeptical of the existence of PSSD. Patients were frequently told that our symptoms were a result of a mental health condition, despite the fact that we had never experienced such symptoms prior to antidepressant treatment.

When I brought some literature on PSSD to my former psychiatrist, she refused to even look at it, dismissing it—and my concerns—as “ridiculous.” I have also raised it with my current GP, but he’s not interested in hearing about it. – Ellen, age 48, PSSD for 14 years

That view is now shifting due to the dedicated work of researchers, whose documentation of PSSD cases led to the recognition of PSSD as an iatrogenic (meaning caused by medical treatment) condition by the European Medicines Agency. Though not yet recognised outside of Europe, doctors around the world are slowly becoming more aware of the risk of Post SSRI/SNRI Sexual Dysfunction. Health Canada put SSRIs and SNRIs under review for long-term sexual dysfunction in 2018 and the report is expected soon.

For those of us who do not regain our sexuality, or only partially regain it, the future is a long road of reaching acceptance and rebuilding our sense of self:

The trauma and grief and loss can’t be blocked down by a vision of miracle reversal. To be honest it’s more of a slow rebirth. Like dying and coming back to life as a new person entirely. – Kara, age 29, PSSD for 7 years

Patient activist groups are now springing up around the world to advocate for recognition and more research into the causes, rates, and potential treatments of this disorder. Our group – PSSD Canada – was established in May 2020 to advocate for PSSD sufferers in our home country of Canada and internationally. We are explicitly not anti-psychiatry or against the use of antidepressant medication, but we advocate for greater research, awareness, and transparency of the potential health risks so that patients can be better informed about using these drugs. We collect personal stories, academic sources, and professional statements of support at our website and invite others to be in touch with us  (pssdcanada@gmail.com) as we learn more about this condition.  

Emily Grey is the co-coordinator of PSSD Canada.

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12 Comments

  1. L says:

    I have been suffering from it for 7 years. In my case some desire and pleasure of intimacy has survived, but all sexual excitement and pleasure from my genitals has disappeared, in particular the clitoris is as if it were no longer there and no longer gives any erogenous sensation. This is creepy and unfair. I hope that those who have the power and the duty to intervene will do so as soon as possible. Those who take this drug must be warned properly, and those who have already been harmed have the right to be treated. Finding the cure requires research, and research requires recognition of the problem and funding. It is not possible to harm people with treatments that should improve their lives and then abandon them. Thank you for this article. I wish the guys suffering from pssd would all commit to something like this or at least leave a simple comment. We can’t get anyone’s attention if we remain silent in the dark with our injuries.

  2. L says:

    I’ll add a few words for anyone arriving with pssd. Get in touch with the pssd community and help move things along. Go to Rxisk.org (fill in the adverse event report) and pssdforum.org, which are currently the main references for international community of pssd sufferers. If there is something you think has brought you improvement, share it, there are some really desperate people among us.

    • Ben says:

      I’m male, I’ve had PSSD for 8 years.
      Besides the sexual symptoms which includes complete loss of sexual desire (amongst other things), I’ve suffered severe cognitive impairment and emotional numbing.
      To say it has devastated my life would be an understatement.
      It’s shocking and ridiculous that the medical community doesn’t take this seriously and does nothing about it.
      Thank you for bringing awareness to this.

  3. Shawn says:

    I’m a male and I’ve had this condition for 10 years, since going on citalopram at 14. My life has been severely altered and I feel I’ve missed out on some of the most important years of my life.

    Thank you for writing about this underreported condition here.

  4. Winnie says:

    Thank you so much for covering this. I have this condition and it’s so hard to function. It feels like my clitoris has been cut clean off. So traumatic. I hope this starts getting more mainstream attention soon. People may not even realize what’s causing it if they don’t know about the link to SSRIs. Especially women since our sexual health issues get dismissed as psychological so much.

    • Dan says:

      I am a 42 year old male and I have had these symptoms for 5 months. I have lost a great deal of sensation in my penis and my arousal and libido are significantly diminished.

      As it has been 5 months, I do have hope for a natural recovery, but I also know that this might be permanent. It is scary and I didn’t ask for it.

      A primary care physician, psychiatrist, and urologist all assured me this drug, sertraline, wouldn’t cause any long term effects and that those experienced on the drug would return after 2 weeks. They also acted bewildered when I brought up the persisting difficulties and even dismissed it as anxiety or depression related and offered more antidepressants as the solution!

      Doctors everywhere must warn their patients of this disorder or only prescribe safer alternatives starting NOW.

  5. E says:

    I’m a 40 year old female from Australia. I took Luvox around 3 years ago now and the effects have been devastating to my current relationship and my mental health. I have approached a few GP’s here very hesitantly and have left bursting into tears feeling like I’m crazy and it’s all in my head and due to deep depression. The toll on my relationship has been so difficult. I took Luvox when my first born was about 8 months old as a suffered severely from post natal depression. After being on it for only a couple of weeks the complete lack of sexual desire and emotional numbness made me feel so ‘un-human’ it was worse than the depression itself. I’ve never felt so disconnected from the truth of who I am, so robotic and unable to authentically connect with others at a deep level, even with my daughter which has created immense guilt and sadness as a mother. Although I have retained physical sensation and the ability to orgasm none of that seems to matter due to my complete lack of interest or sexual desire. There is no passion, no feeling in my touch… even when I hug my partner it feels like going through the motions. I am left completely incapable of intimacy on any level. We have not kissed passionately since being on Luvox, merely a peck on the lips is all I can bring myself to do. I still find my partner attractive but don’t ‘feel’ attraction anymore. Emotionally I am exhausted, defeated and unable to see the light. I hope this condition can be taken seriously and every person offered these drugs is made aware of the risks.

    Thank you for bringing awareness to PSSD.

  6. hell on earth says:

    Please be aware that the term pssd is misleading in a sense it only talks about ssri and snri (like your article too). I went into this trap and got the same life destroying condition from non ssri. I know many others that got the same destiny. It’s more rare but my advice is to avoid all psychiatric drugs as much as possible. They are all random acting and risky.

  7. R says:

    I was forced to take this drugs when I was just a minor and now I’m stripped away from my sexuality and emotions. PSSD is hell on earth. I’m planning to get assisted suicide soon, I’m living in hell and too traumatized about what the mental health system did to me 🙁 I’ve never got to experience my sexuality before it was stripped away from me because of a med I didn’t wanted to take

    • Amanda A says:

      Health care provider here and ashamed to say this is this first I’ve ever heard this. Thank you. My heart and fury go out to all of you whose providers have told you that your experience is imaginary.

  8. Kk88 says:

    11 years for me. This impacts the quality of my life every day, and it’s not just my sex drive – my drive and spark for every other element of my life went with it too.

    The worst part is trying to discuss this with drs and being shut down and having SSRI’s pushed as ‘completely safe’ – I’m certain they have permenantly changed my brains neurology – I feel like a 70 year old woman at 33.