You have probably never heard of Post-SSRI Sexual Dysfunction (PSSD), but if you have ever been prescribed a drug for depression, or are thinking of consulting a psychiatrist because of this symptom, you need to be aware of it. It is a tragic situation and all the more so since it is completely unnecessary. This is because so-called antidepressants should not be prescribed at all.

It is well known, or ought to be, that one type of drug commonly prescribed for the symptom of depression, called an SSRI (Selective Serotonin Reuptake Inhibitor), may result in the following harms, among many others – and please note, ‘harms’, not what are euphemistically and misleadingly called side effects. These include emotional numbing, suicidal thoughts, akathisia (a horrible condition of physical and emotional restlessness), and sexual dysfunction. For today’s post I shall focus on the last-mentioned.

Sexual dysfunction
What the bland-sounding sexual dysfunction means, as described by those unfortunates who have suffered or continue to suffer from it, are the following: decrease in genital sensation or numbness in the genital area, pleasureless or weak orgasms, decreased sex drive, erectile dysfunction, and premature ejaculation. In addition, women may experience vaginal dryness and nipple insensitivity.

There is a support group for people with this problem, PSSD Network. On one of their website pages, we find heart-breaking statements from sufferers, of which the following is a sample:

  • I have been suffering with numb genitals, pleasureless orgasms, zero libido, and numb emotion, since taking an SSRI antidepressant in 2007. I have been off the drug for 13 years, and I am still suffering all of these symptoms, every day. I am a PSSD sufferer.
  • I have a physical disability. Now, after 10 years of SSRIs and antipsychotics I also have a mental one. Bland mind, intelligence loss, emotional numbing, and myriad others. I just exist.
  • SSRI took my emotions, my ability to feel love for my family, my energy and left me bedridden with anhedonia – I am only 22!
  • My husband has PSSD. He was treated with citalopram for anxiety. Now he has stopped taking the drug. This SSRI has prevented us from having any type of physical relationship. We love each other very much but we have no ability to share that love in a physical sense.

These stories are tragic and it is only right and proper that efforts are being made to help PSSD sufferers.

What can be done?
A researcher in Italy, Dr Robert Melcangi, who admits he does not know the mechanism of PSSD or how to cure it, nonetheless is busily working away studying rats. It seems one can observe changes in mounting behaviour and ejaculation in male rats dosed with an SSRI, though how this relates to humans is unclear. Dr Melcangi also tells us that he intends somehow to explore the effects of SSRIs on the sexuality of female rats, and eventually to experiment on human subjects. However, the bleak fact remains that whatever happens or does not happen in rats, will tell us nothing about what may or may not happen in humans.

I fear that research in rats is only raising false hopes. Sufferers do not want to wait years or decades for the results of these experiments, in the curious language of medical research, to be ‘translated’ into treatment for humans. They want treatment now, if only it were possible.

Prevention is better than cure
If there is no early prospect for cure or alleviation of this calamitous condition, then at least let us concentrate on prevention. Some research is also aimed at trying to discover genetic factors that may point to an increased risk of developing PSSD, so that patients can be presented with this information in order to make an ‘informed choice’ of whether to accept treatment with an SSRI. This implies, however, that SSRIs are a legitimate and potentially helpful treatment for patients deemed to be suffering from the disorders for which SSRIs are ‘indicated’ – another medical jargon word – meaning that a treatment for a certain condition should be prescribed. For example, if a patient has type 1 diabetes, then insulin is indicated.

However, unlike diabetes which can be demonstrated by a blood test, in the realm of so-called psychiatric disorders, diagnosis of necessity is entirely subjective. Nonetheless, there is a list of six condition for which the SSRI drug called Zoloft (sertraline) is said to be indicated, as set out in the manufacturer’s product information:

  • MDD – major depressive disorder
  • OCD – obsessive-compulsive disorder
  • PD – panic disorder
  • PTSD – post-traumatic stress disorder
  • SAD – seasonal affective disorder
  • PMDD – pre-menstrual dysphoria disorder

So many disorders!

The word ‘disorder’ implies the presence of a some sort of brain abnormality, but unfortunately, or rather I should say, fortunately, no objective evidence has ever been found in support of this idea.

Thus, if a patient consults a psychiatrist and is deemed to be suffering from one or more of these so-called disorders, according to orthodox psychiatric thinking and as encouraged by the product information for Zoloft, this drug should be prescribed!

Informed consent?
Let us make a huge assumption: that the above-mentioned disorders exist and can be accurately diagnosed. And further, let us make the highly unlikely assumption that a test will become available to determine whether someone has an increased propensity to suffer PSSD, then the conversation would presumably start something like this:

     Psychiatrist: I have diagnosed you with major depressive disorder and recommend you take the SSRI drug called Zoloft. However, there is an x per cent chance that, apart from many other harms, you may suffer PSSD which may be permanent. Would you like to take it?

A guaranteed way to prevent PSSD
Apart from their dubious efficacy, SSRIs and similar drugs may cause serious harms; they should be taken off the market.

Text copyright © Gabriel Symonds

Picture credit: Nick Fewings on Unsplash