Patients taking antidepressants are being warned to beware of side-effects that could leave them ‘asexual’ even after they stop using them – a problem that could affect millions of Brits.
Selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressant drug in the UK, are relied upon by one in eight Brits – 8.6million in all – who are dealing with mental health issues like anxiety and depression.
Common SSRIs prescribed in the UK include citalopram, fluoxetine and sertraline, sometimes known by brand names Cipramil, Prozac and Lustral – but their use has been linked to long-term and even permanent sexual dysfunction by researchers.
The NHS has warned that side effects such as a loss of libido and achieving orgasm, lower sperm count and erectile dysfunction ‘can persist’ after taking them – and patients have described feeling ‘carved out’, relationships wrecked, from their use.
Men and women say SSRI side-effects have hampered their sex lives, even after coming off of the medications – a condition known as Post-SSRI Sexual Dysfunction (PSSD), which is not officially recognised by UK health authorities.
For millions, antidepressants can be a life-saving drug – but the authors of a US petition urging more warnings to be applied to the drugs say it can be ‘impossible… to weigh the benefits of treatment against the harms’.
Has your sex drive been hampered by SSRIs? Email [email protected]
Click here to resize this module
Antidepressant side-effects affecting men and women have been well-known for decades, following early trials in the 1980s – but the drugs have become widespread in their use for treatment of depression, anxiety and other mental health conditions.
One London student, speaking on the condition of anonymity, previously told the Mail his genitals had been left ‘basically inanimate’ after he began taking the SSRI escitalopram.
He said: ‘This area of my life used to be so much fun, and now it’s a source of anxiety and has become a dark place in my head.
‘It feels like someone has gone into my brain with a scalpel, carved some bits out and left me with this strange, numb, asexual person.
‘No doctor will even consider that it might be related to the SSRI.’
Rebecca Graham, a British woman in her 40s, said she had ‘given up on the idea of children’ – but that she had been ‘gaslit’ by doctors who refused to believe SSRIs were causing 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 percent of people in England in their lifetime, according to the Mental Health Foundation.
Dr Ben Davis, an expert on sexual medicine, said antidepressants are often prescribed quickly – perhaps too quickly.
‘There are people for whom they are life-saving medication,’ he told BBC News.
‘But the other side is a 10-minute consultation with someone you’ve never met before, with the pressure of someone who is seeing 30 people a day.
‘Do good decisions about long term medication happen in that environment? I think not.’
Click here to resize this module
Advocacy groups such as the PSSD Network have called for better recognition of the condition and better support for those experiencing a loss of libido.
But their campaigning is limited by a lack of research being carried out into the long-term repercussions of SSRI use.
In the US, a Harvard molecular biologist has lodged a lawsuit against the Food and Drug Administration (FDA) for allegedly ignoring requests to slap warnings on SSRIs about the long-term and even permanent repercussions of their use.
Dr Antonei Csoka, an adviser to the PSSD Network, says in his filings that the FDA never followed up on a petition he counter-signed in 2018 begging officials to require drug companies to add the alerts to their medicines.
He believes long-term SSRI use can rewrite DNA – which can in turn affect the genes relating to sexual function. But exactly why it happens with some patients and not others is unknown – and research remains lacking.
Dr Csoka said: ‘Without adequate warnings about the risk of potentially permanent damage to sexual function, patients and health care professionals cannot weigh the benefits of the drugs’ use against the potential harms.’
Scientists do not know for sure how many people are affected by PSSD, though 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 around five to 15 percent of people on antidepressants developed sexual side effects such as erectile dysfunction and lack of sex drive after taking SSRIs and SNRIs.
Patients sharing their stories through the PSSD Network have described a range of disturbances 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 various antidepressants at different points when he was 16 to deal with the death of his father and was able to stop taking them at 20.
Now, at 25 and off the meds, 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 constant overactive bladder, urination, I have severe erectile dysfunction and premature ejaculation… I never had any of this before the meds.’
He added: ‘I have seen a urologist that specializes in sexual health acknowledges the existence of PSSD; he conducted an ultrasound on my privates and told me that I have fibrosis in it, and he said it’s very common to see that in men who are on antidepressants for a while.’
A female patient, meanwhile, stopped taking her antidepressant three years ago, but said now her sexuality is gone.
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 ‘asexual now from the medicine.’
He said: ‘I used to be able to look at people that I was attracted to and you feel something but now I feel nothing, it’s just like looking at the wall. Basically taking away almost all positive emotions, they went from 100 to maybe less than one, that’s how strong it is.’
He added that the hardest part of the general emotional blunting caused by the medicines: ‘When you hug the people you love, your mother, your father, your nephew, you don’t feel anything… You cannot get any emotional bond at all.’
Dr Csoka has been researching sexual dysfunction linked to antidepressants since the early 2000s and was one of the first to posit that the medicines, as a side effect of driving up serotonin levels in the brain, caused DNA modifications that affect the activity of genes that regulate sexual function.
He told the Guardian: ‘Various scientists, including myself, have published studies showing that an SSRI can change epigenetics and human cells.
‘If that’s happening, then those cells or tissues may not immediately revert back to how they were once treatment stops. It’s as though an imprint has been left there. However, it’s still not known precisely what these epigenetic changes are. So what we need to do is narrow it down – what is happening?’
His lawsuit filed in the US District Court for the District of Columbia seeks to force the FDA to issue a decision on the petition.
A 2022 meta-analysis in Frontiers in Pharmacology found that SSRIs have ‘a statistically significant impairment on semen quality, such as sperm concentration, sperm morphology, sperm motility,’ the researchers wrote. However, semen volume was not impacted.
But it is not possible to say whether SSRI use is having an effect on Britain’s birth rate.
In England, antidepressant prescriptions more than tripled between 1998 and 2018, according to an analytical study of prescribing data.
In the same time period, average births per woman in the UK rose from 1.73 to a high of 1.94 in 2010 – falling to 1.65 in 2018, according to the Office for National Statistics.
Robert Johnson is a UK-based business writer specializing in finance and entrepreneurship. With an eye for market trends and a keen interest in the corporate world, he offers readers valuable insights into business developments.
