This page has been adapted from an information sheet produced by:
The Canadian Post-SSRI Sexual Dysfunction Society
What is PSSD ?
Post-SSRI/SNRI Sexual Dysfunction (PSSD) is a disorder that reduces or eliminates sexual functioning despite stopping treatment with SSRI or SNRI medications.
Symptoms of Sexual Dysfunction are common side-effects of SSRI and SNRI use, but some people report ongoing or worsened sexual dysfunction even after stopping the medication. For some, the symptoms start when they stop taking the medication and persist for more than 6 months - this is known as PSSD.
PSSD can be emotionally devastating. It can cause strain on personal relationships, and diminish quality of life.
PSSD is an understudied and under reported sexual health condition. Public awareness and further research is essential for the treatment of this disorder.
Health Canada has recognized case reports of PSSD, but argues there is not enough research to make a clear conclusion about the relationship between long term sexual dysfunction and SSRIs/SNRIs.
Health Canada recommends doctors warn patients of the risk of possible long term sexual dysfunction before starting treatment with these medications [REF].
What are SSRI and SNRI medications?
SSRI (Selective Serotonin Reuptake Inhibitor) and SNRI (Serotonin and norepinephrine reuptake inhibitor) medications can be very helpful to treat people with long-term depressed mood, anxiety, PTSD, panic disorder, and severe phobias.For more information about the use and benefits of these medications, click here.
It has been found that ALL SSRI and SNRI medications have been linked to PSSD.
Common SSRI and SNRI medications include:
SSRI Medications
fluoxetine (Prozac)
paroxetine (Paxil)
fluvoxamine (Luvox)
citalopram (Celexa)
escitalopram (Cipralex)
sertraline (Zoloft)
SNRI Medications
enlafaxine (Effexor)
duloxetine (Cymbalta)
levomilnacipran (Fetzima)
desvenlafaxine (Pristiq)
What is the prevalence, what is the risk?
Research has not yet been done to understand how common PSSD disorder is. Therefore, it is unknown what percentage of people who take SSRI/SNRIs develop PSSD or how common it is for people recover from PSSD.
Health Canada has stated that PSSD was likely underreported due to lack of information and stigma. Due to the lack of research, lack of knowledge in the medical community, stigma about sexuality, and shame about sexual issues, PSSD is a largely unknown disorder.
What are some of the possible the symptoms of PSSD?
Genital anesthesia (numbness) or reduced genital sensation / sensitivity
Genital paresthesia (burning or prickling sensation)
Anorgasmia (delayed or eliminated ability to orgasm)
Pleasureless, weak, or “muted” orgasms
Erectile dysfunction / decreased vaginal lubrication
Reduced or eliminated sexual desire, libido, and sex drive
Reduced or eliminated response to sexual stimuli
Reduced or eliminated nocturnal erections
Premature or delayed ejaculation
Reduced or eliminated sensitivity in sexually sensitive areas (e.g nipples)
Tingling or numbness can be a medical emergency (such as cauda equina syndrome) and if those symptoms suddenly come up or worsen, you should go to the emergency room.
The current recognized diagnostic criteria can be found here.
How do you know if and when you may be experiencing PSSD?
When symptoms persist for more than 6 months after taking the last dose of the medication, it is called Post-SSRI Sexual Dysfunction or Post-SSRI/SNRI Sexual Dysfunction (PSSD) which may or may not resolve with time. PSSD can endure for decades or indefinitely.
PSSD can be hard to diagnose because some of the symptoms of PSSD can mimic symptoms of depression
When presented with PSSD symptoms, it is common for doctors to think that they are caused by depression or another mental illness
If you did not experience sexual dysfunction as part of your depression before starting the medications but you develop it either during or soon after starting the medications and it still continues after you stop the drug - this may be related to the medications rather than your mental health
If your mental health and mood have improved (if emotional and psychological parts of your depression have gotten better) but you are still experiencing sexual dysfunction, this may be related to the medication rather than your mental health
The following symptoms of PSSD are are not symptoms of depression:
It is important to note that sexual desire and sexual performance can change for various reasons such as stress, or sometimes for no reason at all. Erectile dysfunction, low sex drive, and anorgasmia can occur for a variety of reasons such as stress or other medical conditions. If you are experiencing ongoing sexual symptoms that are bothersome for you, it is important to see a doctor who is knowledgeable about sexual health issues.
How common is PSSD?
It remains unknown what percentage of people who take these medications will develop PSSD. Research has not yet been done to understand how common this disorder is. It is currently unknown how commonly people recover from PSSD.
Due to a lack of research and awareness in the medical community, stigma about sexuality, and shame about sexual issues, PSSD is a largely unknown disorder.
Health Canada has stated that PSSD was likely underreported due to lack of information and stigma.
What Can People Do About It?
If you believe you are experiencing symptoms of PSSD, it may be helpful to bring existing research on PSSD to show your doctor to reduce the risk of being misdiagnosed. Various sources can be found at the PSSD Canada website.
You can ask your doctor for a referral to see a specialist there if you believe you may have PSSD. Your family doctor, a sexual medicine specialist, a urologist, a psychiatrist, or a psychologist can diagnose PSSD.
There is currently no reliable treatment to manage symptoms of PSSD, but working with a therapist who is educated about PSSD and its unique impacts can help to reduce emotional distress.
Connecting with others experiencing PSSD to find community and support and having your experience with PSSD acknowledged and validated by your healthcare provider can also help people cope better with PSSD.
Where To Go For Information and Support
PSSD Canada (LINK HERE)
PSSD Canada exists to bring together people in Canada suffering from this condition and advocate for recognition, research, and greater awareness within the medical community and the public concerning the sexual risks of antidepressants.
PSSD Network (LINK HERE)
A collaborative group of volunteers who have been affected by Post-SSRI Sexual Dysfunction. Their goals are to accelerate research efforts by raising awareness and promoting various fundraisers
Canadian Association for Mental Health - Antidepressant Drug Use Information (LINK HERE)
Information about the use and benefits of SSRI and SNRI medications.
Mood Disorders Association of BC (LINK HERE)
Information on support groups around the British Columbia. Visit the website or call 604-873-0103 (in the Lower Mainland) or 1-855-282-7979 (in the rest of BC) for resources and information on mood disorders.
BC Partners for Mental Health and Substance Use Information (LINK HERE)
Visit for info sheets and personal stories about depression. You’ll also find more information, tips and self-tests to help you understand many different mental health problems.
Yassie Pirani (she/her), MSW RSW RCC
Contact: willowleafcounselling.ca (open to British Columbia residents only)
Participate in Research on PSSD
If you are interested in learning more about PSSD research or ongoing studies, please CLICK HERE.