Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence

Epidemiol Psychiatr Sci. 2024 Sep 18:33:e40. doi: 10.1017/S2045796024000441.

Abstract

While sexual dysfunction is a well-known side effect of taking selective serotonin reuptake inhibitors (SSRIs), in an undetermined number of patients, sexual function does not return to pre-drug baseline after stopping SSRIs. The condition is known as post-SSRI sexual dysfunction (PSSD) and is characterised most commonly by genital numbness, pleasureless or weak orgasm, loss of libido and erectile dysfunction. This article provides a commentary on the incidence and prevalence of PSSD based on a combination of academic literature as well as clinical and research experience. A number of obstacles to quantifying the occurrence of PSSD are outlined including difficulty in designing a suitable study method. Other contextual obstacles include patient embarrassment at raising sexual concerns, the response of healthcare professionals, inability to stop an antidepressant due to withdrawal issues in a proportion of patients and patient unawareness that their sexual difficulties are linked to prior medication compounded by variability of online information and a lack of information aimed at public education. A definition of PSSD with diagnostic criteria has been published. A MedDRA code for PSSD has also been introduced, but this is yet to be adopted by regulators.

Keywords: adverse effects; antidepressants; sexual dysfunction; suicide.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Incidence
  • Male
  • Prevalence
  • Selective Serotonin Reuptake Inhibitors* / administration & dosage
  • Selective Serotonin Reuptake Inhibitors* / adverse effects
  • Sexual Dysfunction, Physiological* / chemically induced
  • Sexual Dysfunction, Physiological* / diagnosis
  • Sexual Dysfunction, Physiological* / epidemiology
  • Sexual Dysfunction, Physiological* / psychology
  • Sexual Dysfunctions, Psychological* / chemically induced
  • Sexual Dysfunctions, Psychological* / diagnosis
  • Sexual Dysfunctions, Psychological* / epidemiology
  • Sexual Dysfunctions, Psychological* / psychology

Substances

  • Selective Serotonin Reuptake Inhibitors