Last Updated on September 19, 2026 by
Alternative to Meds Editorial Team
Medically Reviewed by ATMC Clinical Review Team
Table of Contents:
- Video: Success of the ATMC Program
- PSSD — What is Post-SSRI Sexual Dysfunction?
- Symptoms of PSSD
- New Regulations to Inform Patients about Sexual Side Effects from SSRI Antidepressants
- Countries that have Added Warnings to Packaging Regarding PSSD
- Treatment Options for Neurotoxin Exposures
- ATMCs Approaches to Natural Healing
In almost every country in the world, PSSD is acknowledged to be caused by SSRIs and other antidepressants, but not in the US. Find out more about PSSD so you can discuss the information provided below with your prescriber.
Have you suffered from loss of sexual health after SSRIs?
PSSD — What is Post-SSRI Sexual Dysfunction?
PSSD is a newly documented sexual health risk after taking SSRI antidepressants. Research that has recently surfaced from Horowitz, et al and many others, has demonstrated PSSD can occur after SSRI use. This condition is described as loss of sexual pleasure that persists after using SSRI antidepressants. The condition can onset and persist even after discontinuation of the antidepressant.1
The condition of PSSD can afflict both males and females. The list of PSSD symptoms is quite extensive, (see below for a comprehensive list of PSSD side effects) and the consequences to quality of life can be devastating.2-4
Symptoms of PSSD can include:
- Anesthesia of the genitals
- Erectile dysfunction
- Reduction or loss of semen in males
- Reduction or loss of lubrication in females
- Loss of libido (sex drive)
- Inability of orgasm in females
- Inability to ejaculate in males
- Anhedonia (general inability to feel pleasure)
- Apathy
- Depression
- Fatigue
- Loss of ability to feel attraction, love
- Emotional blunting, numbness
- Shrinkage of genitalia
- Cognitive impoverishment (loss of imagination, creative thought, dreams)
- Brain fog
- Memory loss, short-term or long-term
- “Blank mind” phenomena
The exact mechanisms which cause PSSD are still being analyzed, but the diagnosis itself is clearly attributable to prior use of SSRIs, SNRIs, and other types of antidepressants. Rigorous research was done to exclude all other potential causal factors. The researchers warn that prescribers need to understand the precise features of PSSD which may lead to misdiagnosing the condition. If this occurs, further complications can arise from harmful treatments including reinstating the medication that caused the condition to onset.
PSSD has been recognized in Europe, Ireland, and the UK since 2019 but has been slow to enter the medical vocabulary in other countries, including the US. However, awareness of this ruinous condition is slowly growing. In Europe, PSSD is referred to as “persistent sexual dysfunction after SSRI withdrawal.”
Patients describe the condition as “chemical castration,” feeling they have been robbed of the ability to feel pleasure, love, and stripped of emotional connections with others.5
New Regulations to Inform Patients about Sexual Side Effects from SSRI Antidepressants
Sexual side effects from SSRI antidepressants have been a well-documented liability in the medical literature for quite a long time.6 PSSD is the newest of these antidepressant-related side effects to be recognized. Yet, according to the experts in the field, most prescribers are likely unaware of this phenomenon. As a consequence, their patients may not be fully informed of this and other risks of sexual dysfunction after SSRI use or SSRI withdrawal. According to the research, sexual side effects are associated with not only SSRIs, but also SNRIs, TCAs (tricyclics), and other classifications of antidepressant medications.
As far back as 2019, the European Medicines Agency (equivalent of the FDA in the US) called for updated patient/prescriber information on PSSD to be added to packaging for a very long list of drugs.6
New Patient Guidelines regarding PSSD (persisting sexual side effects after antidepressants) was ordered for these drugs:
- Duloxetine
- Fluoxetine
- Citalopram
- Vortioxetine
- Escitalopram
- Fluvoxamine
- Sertraline
- Desvenlafaxine
- Paroxetine
- Venlafaxine
- Milnacipran
- Clomipramine
- all SSRIs
- all SNRIs
Countries that have Added Warnings Regarding PSSD to Drug Packaging
Not every doctor or patient studies drug packaging thoroughly. But regulatory bodies have taken steps to mandate updated information about PSSD and other sexual risks on drug packaging. If you live in any of the countries listed below, there is information you can read, and encourage your prescriber to read if necessary.
If you live in the USA you will have to inform your prescriber yourself, as the warnings are missing on drug labels.
Medical Agencies from many around the world that have added PSSD warnings include:
- European Medical Agency (2019)
- HPRA in Ireland (2019)
- MHRA in the UK (2019)
- Health Canada (2021)
- Hong Kong Dept of Health (2022)
- Australian Dept of Health (2024)
- Malaysian Pharmaceutical Regulators (2025)
As of December 2025, FDA regulators have kept PSSD warnings hidden from the public, although information letters about PSSD risks associated with antidepressants were sent back in 2019.
Treatment Options for Neurotoxin Exposures
Treatment for PSSD is being researched. Drug companies are probably desperately searching for “some drug, any drug” that will reverse the condition. According to large clinical studies, none have been found.9,10 Likely, none will be found. Antidepressants are not healing agents. They are numbing agents, and can injure the CNS (central nervous system). When a substance damages neurons and receptors, that substance is called neurotoxic. There are many, many neurotoxins we can be exposed to in everyday life, let alone from medication.
However, a basic understanding of how antidepressants may disable neurotransmission can lead to helpful methods to reverse and heal damaged neuronal function. The CNS, including the brain, can adapt and make improvements in function — but the basic building blocks and raw material must be provided to be able to accomplish that.
No drug can create hormones and neurotransmitters. There are, however, substances that can aid in neurotransmitter rehabilitation that are found in foods, and supplementation.
Where neurotoxin exposure has occurred, neurotoxin removal has been shown effective for supporting the natural healing process.
ATMCs Approaches to Natural Healing
ATMC has been helping people with mental health for nearly 20 years, with great success. The foundational principles on which treatment programs are built do not depend on labels, or drug-based treatment.
The root cause of any non-optimum condition must be explored in order to arrive at a solution that works. Not by disabling nerve endings or numbing symptoms with more drugs.
Many of our clients have suffered for years with chronic conditions that have not responded to drug-based treatment. In fact, in many cases, drugs did further harm. Improperly done medication withdrawal is renowned for persisting difficulties that can be avoided and overcome when proper tapering methods are employed. Our goal is to help a client find and treat root causes for troubling symptoms. This can mean safe medication withdrawal, therapeutically effective diet correction and supplementation based on orthomolecular medicine, toxin removal, and a wide range of holistic psychological therapies and physical exercise and comfort therapies that can reduce stress, boost mood naturally, improve quality of life, and kick-start many facets of recovery.7,8 Find out more about cold-plunge therapy, sound healing therapy, Equine therapy, and much more on our services pages.
Whatever persisting symptoms one is experiencing, you can call us for treatment options that can boost your progress on your personal healing journey. ATMC is insurance friendly, and our hand-picked staff is dedicated to helping you. Call today for more information that may help guide your path to natural mental health, without relying on medication for life.
for Help with Sexual Dysfunction Caused by Antidepressants
Sources:
1. Peleg LC, Rabinovitch D, Lavie Y, Rabbie DM, Horowitz I, Fruchter E, and Gruenwald I. (2022) Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors. Sex Med Rev 10, 91-98. [cited 2025 Nov 27]
2. Trøstheim M, Eikemo M, Meir R, Hansen I, Paul E, Kroll SL, Garland EL, Leknes S. Assessment of Anhedonia in Adults With and Without Mental Illness: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020 Aug 3;3(8):e2013233. doi: 10.1001/jamanetworkopen.2020.13233. PMID: 32789515; PMCID: PMC7116156. [cited 2025 Nov 27]
3. Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92(1):1-6. doi: 10.1159/000354931. Epub 2013 Nov 21. PMID: 24281298.[cited 2025 Nov 27]
4. Tocco C SSRI-induced Emotional Blunting published online, accepted by CUNY Academic Works 2022 [cited 2025 Nov 27]
5. Ben-Sheetrit J, Hermon Y, Birkenfeld S, Gutman Y, Csoka AB, Toren P. Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants. Ann Gen Psychiatry. 2023 Apr 21;22(1):15. doi: 10.1186/s12991-023-00447-0. PMID: 37085865; PMCID: PMC10122283.[cited 2025 Nov 27]
6. European Medicines Agency, PRAC Recommendations on Signals published online 11 June 2019 [cited 2025 Nov 27]
7. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017 Dec;106:48-56. doi: 10.1016/j.maturitas.2017.09.003. Epub 2017 Sep 7. PMID: 29150166. [cited 2025 Nov 27]
8. Adkins EA, Brunst KJ. Impacts of Fluoride Neurotoxicity and Mitochondrial Dysfunction on Cognition and Mental Health: A Literature Review. Int J Environ Res Public Health. 2021 Dec 7;18(24):12884. doi: 10.3390/ijerph182412884. PMID: 34948493; PMCID: PMC8700808. [cited 2025 Nov 27]
9. Tran FD, Bichai GH, Kravetz Z, Meriden Z. Management of Antidepressant-Induced Sexual Dysfunction: A Literature Review. Cureus. 2025 Aug 15;17(8):e90170. doi: 10.7759/cureus.90170. PMID: 40955264; PMCID: PMC12433685. [cited 2025 Nov 27]
10. Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database Syst Rev. 2013 May 31;2013(5):CD003382. doi: 10.1002/14651858.CD003382.pub3. PMID: 23728643; PMCID: PMC12052305. [cited 2025 Nov 27]
Originally Published November 27, 2025 by Diane Ridaeus
ATMC Clinical Review Team
The ATMC Clinical Review Team includes licensed physicians and experienced healthcare professionals dedicated to ensuring the accuracy, quality, and integrity of our medical content. The team reviews articles for clinical accuracy, evidence-based guidance, and relevance while supporting Alternative to Meds Center’s whole-person approach to mental health, recovery, and long-term wellness.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.