Sexual dysfunction warning to millions taking antidepressants

Patients taking antidepressants are being warned to be wary of side effects that could leave them ‘asexual’ even after stopping – a problem that could affect millions of Brits.

Selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressants in Britain, are used by one in eight Brits (8.6 million in total) dealing with mental health problems such as anxiety and depression.

Common SSRIs prescribed in Britain include citalopram, fluoxetine and sertraline, also known by the brand names Cipramil, Prozac and Lustral – but their use has been linked by researchers to long-term and even permanent sexual dysfunction.

The NHS has warned that side effects such as loss of libido and achieving orgasm, lower sperm count and erectile dysfunction ‘may persist’ after taking it – and patients have described feeling ‘cut out’ by taking it, their relationships destroyed.

Men and women say SSRI side effects have hampered their sex lives even after stopping the drugs – a condition known as Post-SSRI Sexual Dysfunction (PSSD), which is not officially recognized by UK health authorities.

For millions, antidepressants can be a life-saving drug, but the authors of a US petition calling for more warnings on the drugs say it may be ‘impossible… to weigh the benefits of treatment against the harms’ .

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The condition mentioned in the lawsuit is post-SSRI sexual dysfunction (PSSD), which can cause genital numbness, a complete loss of libido, erectile dysfunction and other sexual function problems for years after the drugs are stopped.
Statistics in the US show that fertility rates have fallen, while SSRI prescriptions have risen
Escitalopram – also known by the brand name Lexapro – is one of several SSRI medications prescribed by the NHS
Sertraline is also a commonly prescribed SSRI in Britain. Last year, around 8.6 million Britons were prescribed antidepressants

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The side effects of antidepressants in men and women have been known for decades, following early studies in the 1980s, but the drugs have become widespread in their use to treat depression, anxiety, and other mental health conditions.

A London student, who spoke on condition of anonymity, previously told the Mail that his genitals were left “essentially lifeless” after starting the SSRI escitalopram.

He said: ‘This part of my life used to be so much fun, and now it is a source of anxiety and has become a dark place in my mind.

‘It feels like someone has entered my brain with a scalpel, cut out a few pieces and left me with a strange, numb, asexual person.

“No doctor will even consider that it could be related to the SSRI.”

Rebecca Graham, a British woman in her 40s, said she had “given up on the idea of ​​having children” but was “paralysed” by doctors who refused to believe that SSRIs caused numbness below the waist.

“I feel like I’ve been castrated,” she added.

Despite this, the drugs are readily prescribed to Brits as they try to overcome the conditions, which affect between four and 10 per cent of people in England during their lifetime, according to the Mental Health Foundation.

Dr. Ben Davis, a sexual medicine expert, said antidepressants are often prescribed quickly – perhaps too quickly.

“There are people for whom they are life-saving medicines,” he told BBC News.

‘But the other side is a ten-minute consultation with someone you’ve never met before, with the pressure of someone who sees thirty people a day.

‘Are good decisions about long-term medication made in that environment? I do not think so.’

Warnings have been issued about the long-term use of SSRIs to treat anxiety and depression – with some reporting side effects even after stopping them

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Advocacy groups such as the PSSD Network have called for better recognition of the condition and better support for those who experience a loss of libido.

But their campaigning is limited by a lack of research into the long-term consequences of SSRI use.

In the US, a Harvard molecular biologist has filed a lawsuit against the Food and Drug Administration (FDA) for allegedly ignoring requests to warn SSRIs about the long-term and even permanent consequences of their use.

Dr. Antonei Csoka, an adviser to the PSSD Network, says in his filings that the FDA never acted on a petition he co-signed in 2018 imploring officials to require drug companies to add the warnings to their drugs.

He believes that long-term SSRI use can rewrite DNA, which in turn can affect genes related to sexual function. But exactly why it happens in some patients and not in others is unknown – and research is still lacking.

Dr. Csoka said: ‘Without adequate warnings about the risk of possible permanent damage to sexual function, patients and healthcare professionals cannot weigh the benefits of using the drugs against the possible harms.’

Scientists aren’t sure how many people suffer from PSSD, although more than half of all antidepressant users have reported some degree of sexual dysfunction while taking them.

And a 2018 review of the scientific literature on PSSD found that about five to fifteen percent of people taking antidepressants experienced sexual side effects, such as erectile dysfunction and a lack of sex drive, after taking SSRIs and SNRIs.

Patients who shared their stories through the PSSD Network have described a range of disorders ranging from erectile dysfunction, genital shrinkage and numbness to a lack of any sense of attraction to others and an inability to feel pleasure.

One male patient had been prescribed several antidepressants at age 16 to cope with the death of his father, and was able to stop taking them at age 20.

Now, at age 25 and off medication, he has “extreme genital shrinkage and discomfort, I have neurological dysfunction of the smooth muscle in my penis, causing hypercontraction or persistent arousal disorder.”

“I have an overactive bladder all the time, I have to urinate, I have severe erectile dysfunction and premature ejaculation… I never had this before the meds.”

He added: ‘I have seen a urologist who specializes in sexual health acknowledge the existence of PSSD; he did an ultrasound of my genitals and told me I have fibrosis, and he said it’s very common to see that in men who have been on antidepressants for a while.”

Meanwhile, a female patient stopped taking her antidepressant three years ago but said her sexuality is now gone.

What are antidepressants?

Antidepressants are medications that treat depression symptoms.

There are about 30 different types that can be prescribed.

The NHS says most people with moderate or severe depression see improvement when they take antidepressants. But it notes that this is not the case for everyone.

Side effects vary by person and antidepressant, but may include nausea, headache, dry mouth, and difficulty having sex.

Antidepressants are not addictive, but patients may experience withdrawal symptoms if they suddenly stop taking them or miss a dose.

These can include stomach upset, flu-like symptoms, anxiety, dizziness and vivid dreams.

She said, “My clitoris feels like a dead lump.”

And a third patient who had been taking Lexapro for about three months said he is “now asexual because of the drug.”

He said: ‘I used to be able to look at people I was attracted to and feel something, but now I don’t feel anything, it’s like looking at the wall. By essentially taking away almost all the positive emotions, they went from a hundred to maybe less than one, it’s that strong.”

He added that the hardest part is the general emotional numbing caused by the drugs: “When you hug the people you love, your mother, your father, your nephew, you don’t feel anything… You can’t have any emotional connection at all. ‘

Dr. Csoka has been researching antidepressant-related sexual dysfunction since the early 2000s and was among the first to propose that the drugs, as a side effect of increasing serotonin levels in the brain, caused DNA modifications that affect activity of genes that regulate blood pressure. sexual function.

He told the Guardian: ‘Several scientists, including myself, have published studies showing that an SSRI can alter epigenetics and human cells.

‘If that happens, those cells or tissues may not immediately return to how they were once treatment stops. It’s like an imprint has been left behind. However, it is still not known exactly what these epigenetic changes are. So what we need to do is limit it – what’s happening?’

His lawsuit, filed in the US District Court for the District of Columbia, seeks to force the FDA to make a decision on the petition.

A 2022 meta-analysis in Frontiers in Pharmacology found that SSRIs “have a statistically significant impairment of semen quality, such as sperm concentration, sperm morphology, and sperm motility,” the researchers wrote. However, semen volume was not affected.

But it is not possible to say whether the use of SSRIs has an effect on the birth rate in Britain.

In England, prescriptions for antidepressants more than tripled between 1998 and 2018, according to an analytical study of prescribing data.

Over the same period, the average number of births per woman in Britain rose from 1.73 to a high of 1.94 in 2010, before falling to 1.65 in 2018, according to the Office for National Statistics.


While it’s normal to feel down occasionally, people with depression can feel persistently unhappy for weeks or months.

Depression can affect anyone at any age and is quite common; about one in ten people are likely to experience it at some point in their lives.

Depression is a real health condition that people cannot simply ignore or “get out of.”

The symptoms and effects vary, but may include feeling constantly upset or hopeless, or losing interest in things you used to enjoy.

It can also cause physical symptoms such as difficulty sleeping, fatigue, low appetite or sex drive, and even feeling physical pain.

In extreme cases, this can lead to suicidal thoughts.

Traumatic events can cause this, and people with a family history may be more at risk.

It is important to see a doctor if you think you or someone you know has depression, as it can be controlled with lifestyle changes, therapy, or medication.

Source: NHS Choices

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