Drugs and Sex Don’t Go
Most doctors are told headaches or nausea are the commonest side effects of drugs. Nausea for instance is very common on SSRIs – not surprising as there is a lot of serotonin in the gut.
But an immediate change in sexual functioning is a lot more common than nausea. Close to everyone taking an SSRI will feel some genital numbing.
A one way ticket to losing your money
For over a decade companies were able to play down this risk. One of the tricks was to publicize a case report about a woman who on Prozac was reported as having an orgasm every time she yawned. This made it feel like “Yes sexual effects are common, but it’s a bit of a lottery and who knows you might get lucky”. This is similar to the message still being put out by Lilly to both doctors or patients who enquire about sexual dysfunction.
In fact the chances of getting lucky are close to nil and the costs of the deal that many people entered into were unbelievably high.
For antidepressants and antipsychotics, effects on sexual functioning are far commoner than headaches and nausea. We are slowly finding out that lots of other drugs have effects on sex also. It may be that the sexual effects of drugs rather than nausea or headaches are the commonest effects drugs have.
They are certainly at present the effects most commonly reported to RxISK, although this may be partly because we have courted them, creating the only Drugs and Sex Zone in existence.
The original story
When the SSRIs first launched, everyone who found themselves genitally numb and dysfunctional on Prozac, Paxil and Zoloft and who asked about it were met with a response that “yes but don’t worry this effect wears off once you stop treatment”. Many will have heard that “you can even stop treatment for a weekend if you are going away and you want to enjoy the weekend”. What could be more reassuring than that!
Anyone who stopped treatment and found things were not okay was met with a flat-out response – impossible – must be something wrong with your attitude or you’re still depressed.
Far from it, for a lot of totally normal people, many of whom should never have been on Prozac, Paxil or Zoloft in the first instance, this was the end of normal life and the start of a nightmare. This was PSSD – Post-SSRI Sexual Dysfunction.
I saw my first case in 1998 – a woman taking citalopram. She had noticed that her drug was citalopram hydrobromide. A little bit of research told her that bromides were once used to curb sexual drive. Was this what had happened she asked? Sadly it wasn’t. She made it very very clear that nothing could overcome the profound genital anaesthesia and lack of function she now had.
A recent post on RxISK gives a chilling account of the problem – Buried Alive.
Is it for ever?
With the discovery of the internet, people with PSSD began to come together in groups like Yahoo SSRI sex or PSSD Research. They have been a high powered community from a full range of backgrounds, men and women, old and young alike. The saddest thing according to the people in their 50s who have had families is to see young men and women in their late teens or early twenties discover the site, describe what’s happened to them and ask whether they will be this way for ever.
At the moment as far as anyone knows, the answer is yes. There may be some people who recover but if there are there seems to be no reliable way to get recovery to happen. The PSSD community between them have tried all the obvious things. What might work for one doesn’t for others. At the moment, time does not seem to be a healer.
This is a new kind of patient group – possibly the patient group of the future. A group that has sprung up around a drug induced condition. The original group of this type were the Thalidomide Trust. More recently we have seen FACs – parents united to manage Fetal Anticonvulsant Syndrome. Patients united in this way are likely to be the patient group of the future.
Options tried
The SSRIs act on serotonin – there are serotonin 1 receptors S1, S2 and S3 receptors with drugs acting on (agonists) or blocking (antagonists) each of these. All have been tried and those who have tried them have reported back to others affected. No joy.
The serotonin system interacts with the dopamine system. Dopamine agonists such as cabergolide are well known sexual stimulants, sometimes causing rampant promiscuity in elderly men with Parkinson’s disease. Wellbutrin which is a semi-agonist for dopamine was pushed heavily as a possible treatment. But none of these dopamine system drugs works.
Viagra, Cialis and Levitra the treatments for impotence have been used – to no avail.
Those affected have had themselves investigated and in some cases there are reports of borderline low testosterone but this is likely a consequence of the state not its cause. There is certainly no feminization among the men, and treatment with testosterone does not put things right.
The picture looks different to a similar problem that happens with Propecia – finasteride, a treatment for prostate problems, which also causes persistent sexual dysfunction after treatment has stopped. We have almost 60 reports reports of PSSD and a further 7 Post Drug Sexual Dysfunction (PDSP) reports all linked to finasteride. But men with problems on finasteride report testicular atrophy, which does not happen in PSSD.
How soon does it start?
In either men or women, the problem can start as early as the first few days of treatment. It’s almost like a switch being flipped. It happens on potent SSRIs like paroxetine (Aropax, Paxil, Seroxat), and less potent SSRIs. It happens on the SSRIs marketed as SNRIs like Efexor, Pristiq and Cymbalta all of which are potent serotonin reuptake inhibitors.
It happens on drugs that doctors don’t know are serotonin reuptake inhibitors like nefazodone (Serzone, Dutonin) or ziprasidone (Geodon, Zeldox).
The flip leads to genital numbness and a more general depersonalization or sense of being cut off from things – an emotional numbness. Most people on an SSRI have some emotional numbing anyway but for most of us the problem stops when treatment stops. For some it stays and the apathy blights every aspect of life.
We are dealing here with one of the deepest paradoxes of human nature. Ascetics and mystics advocate a disengagement from the passions for anyone who wants to achieve a proper balance in their life. But PSSD doesn’t bring peace. It profoundly disturbs the spirituality of anyone suffering from it. Far from offering balance, it brings with it a deep sense of pointlessness and aimlessness.
PSSD is more like going blind or deaf on treatment – we lose one of our vital senses – a sense for others. Very few mystics or ascetics have ever advocated being blinded, or deafened or irreversibly cut off from the world in this way. Losing out on the possibility of falling in love means losing out on something that can change a life’s direction completely – one of the most important ways to find out about who we in fact are.
Ways forward?
So we have a condition that can have its onset after only a few doses, that at its heart seems to involve a profound depersonalization. The treatment needs to reverse depersonalization and almost needs to be the opposite of an anaesthetic or analgesic agent – something that restores sensation.
In the next 3 posts we will outline accounts of PSSD, give HeatMaps outlining its distribution, and describe two attempts to put it right.
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Great article. Finally, someone ‘gets it’. They ‘get’ that completely losing your sexuality, does not merely leave you with ‘whats left’. It leaves you with no way of enjoying ‘whats left’ because our sexuality is not negotiable.
Thank you, thank you, thank you… for getting us PSSD victims heard! The drug industry sticks their head in the sand in denial and they continue to tell the Drs. that this is not possible. It is! It is very real! I have had this for more than 5 years and do not have any anxiety or depression issues to blame it on. I was able to overcome my anxiety through natural means but unfortunately it was after I already tried the SSRIs.
Thank you, Dr. Healy, for creating this website and having the guts to speak the truth. I will look forward to your future posts!
Thanks for bringing this problem to the open.
I am sufferor of PSSD ever since I started Seroxat (Paroxetine) and stop using it for 3 years ago.
From the medical field I got zero accountability or help. I am so happy someone is willing to take a stand in this.
Looking forward to the upcoming articles!
Many in the psychology profession are stil balking at recognizing this problem and , worst of all, continue to encourage the use of SSRIs
Thanks for the great review. I am writing about this condition for a magazine in the United States. If anyone with PSSD is willing to be interviewed, anonymous or on the record, please contact me at www[dot]pauljohnscott[dot]com. We would be especially interested in hearing from women with the condition.
I thought Id better put my comment in as I suffered PSSD whilst on Paroxatine and then Citalapram but when I went onto Mirtazapine it seemed to have the opposite effect to the SSRIS, I noticed it reversed it. It did not happen over night though and I only noticed the difference after a year of being on Mirtazapine and upping the dose to 30mg. I hope this can be of some help to people.
Have you discontinued the mirtazapine? If so, what happened then?
I took antidepressants for well over ten years before I heard anything at all about these side effects. What little I was finally told was only about “performance” issues – difficulty with erections, orgasms, etc. (bad enough for sure, but only one part of the problem). No one warned me that my basic interest in sex could be affected – much less my ability to feel love and empathy of any kind. As a result I reproached myself bitterly for years for my lack of passion for life and other people, and lost respect for the person I believed I had become. This is not “treatment-resistant depression”; it’s treatment-induced depression.
I’m not a believer of any kind, but this story from a Protestant preacher who took SSRI’s really spoke to me. I’m glad he finally figured out what was happening to him; there may be millions of people who never do. http://www.christianitytoday.com/ct/2009/march/13.26.html
I was put on Ritalin at age 10 for auditory processing and Antidepressents at age 14 for OCD. I have been off of medications for five years, now 23. The side effects continue with little to no improvement. The medications ruined my brains development, and my life. I’m completely numb and humanly disconnected.
With feelings I found beauty, pleasure, and excitement in life. The ability to love is now gone.
I still can not experience an orgasm, explore the visualization aspect of my imagination, or take pleasure from taste and smell. I have memory and energy loss, depersonalization, and muscle twitches. I never got to find my identity, and have been left completely blank at only 23.
I dropped out of college and now am living at home for life no longer has any purpose. I want to cry over everything but I am so numb I can not.
I’m so sorry, Jackie. Your story is pretty much the exact same as mine, except I started the meds at age 16 or 17. It’s been a while sine you posted… has anything changed?
I don’t know what you people are thanking this site for. It says there is no cure. That’s horrible news! I’m only 20 years old and cannot feel sex. I haven’t even started my life and it’s already ruined! My boyfriend is understanding but he cannot wait forever for me to be able to orgasm. I hate my doctor for doing this to me, for not telling me the side effects. I started on citalopram and only took it for 7 months before I had to stop because I didn’t want the effects becoming permanent. But I have stopped taking any medication for three months now and no sexual feeling has returned. Life sucks.
Amanda
People linked to RxISK are working on a cure. We will get one
David
PSSD is caused by Persistent Desensitization of the 5HTIA Pre synaptic autoreceptor … Since its desensitized it is flooding too much serotonin into the post synaptic 5HITA not knowing when to stop .. since the 5HITA post synaptic is being flooded with too much serotonin it is Inhibiting Dopamine etc in regions of brain that are known to cause apathy and PSSD
How would an agonist work when it won’t attach to the receptor due to its desensitize state !
If they are searching for a cure the best one would be a drug or re-search chemical that can RE-SENSITIZE THE 5HTIA PRE SYNAPTIC AUTO-RECEPTOR .
that would be all what we need
I recently stopped taking citalopram because ive lost all motivation in life and sex for months now, ive switched to taking st johns wort, ginseng and vit b, haven’t been taking these for long but ive been much happier and more motivated, so hopefully this continues, time will tell, you cant take st johns wort with ssri’s and some other anti-depressants, it acts like a maoi type med but its not entirely understood but seems to have a few good effect on encouraging dopamine and serotonin production and uptake aswell as a few other fringe benefits, I got sick of reading stuff but I do feel much better thus far, sex drive is on the up fast to thankfully
Does your sexual feelings came back? I took SSRIs for 2 months n now it has caused me Sexual side effects.Will it fade away with time.I left it 4 months ago.
No, it is permanent. It anesthetizes the feeling so any feelilng that does come back is never what it used to be or anti-climactic. It permanently changes the physiological response… I am so very sorry. I too am a victim for life.
It’s coming back for me at 16 months off medications. My original problem started with premature ovarian failure and Prempro leading to depression and antidepressants (and benzos, Buspar and Lamictal) before realizing it was all far more harmful than helpful. Out of 5 1/2 years since this began, more than 3 were on drugs. Most of the time I had complete dysfunction but there was one combination of antidepressant and hormone replacement therapy that threw my system into complete overdrive and had me feeling like a dog wanting to hump legs! I would love to tell you which drug had that effect but can’t figure out which one of the 8 tried did this. Long story short, I may be one of the lucky ones but I am healing now. It wasn’t permanent for me and I use a vibrator frequently to help with akathisia. Works like a charm!
I have just discovered what is wrong with me. I am tottally, completely and utterly demoralized. In 2008 I was 16 years old. I was prescribed fluoxitine. I remember farting several times when I was on it and it felt like burning. My testicals would be moving by themselves while I was in the bath. I remember getting horrible dreams and paranoia while I was on the drug. I then began to get a rash around the tip of my penus and my penus began to shrink, it has never regained it’s size and my sexual function has not returned. At no point did this help me with depression. At no point was I warned of these type of side effects, nor was I warned that there could be any side effects. Another side effect was that erections started to become weaker and weaker. Until 2 years ago I was completely in denial about being impotant. I am nearly 23 now, the day after my 19th birthday I took a beautiful woman back to mine, I knew I was not going to be able to perform, I just knew it. I remember on one occaision while I was on it it felt like my eyes were going to pop out of my head, it was just weird like the light around me, I can’t explain it. I still get what could be described as “brain fog” from it. I will have to jealously watch on as I fall in love with women knowing they can not be mine, I will have to regret listening to that bitch of a woman who put me on them for the rest of my life. I gained a lot of weight from them too. When I went on them I was around 175lbs, I quickly shot up in weight to around 220lbs in the time I was on them. I have been wondering why the hell this happend and I realise now it is all down to those pills.
The user jackie who posted in 2013, reading your post is exactly how i feel. I am numb to everything. Prescribed seroxat in 1999 and it was only this summer i managed to come off it. But it has left me a shell of a human being, i have no joy or excitement about life no passion nothing. As well as being lifeless it left me virtually impotent.
I just stopped paroxetine a couple of weeks ago after taking it for 3 months (decided to just deal with anxiety and take it for being sick of side effects)and have had sexual problems since. Im just finding out this might be permenent.WTF!!! The doctor that perscribed me that crap never even mentioned anything at all about sexual side effects much less losing my ability to finish!! 35;no kids….life sucks
Marco are you from italy? I’m a 26 years-old guy with pssd too. We are planning a study in Milan regarding this fucking condition. We need your help, if possible. Let me know, thanks
Did you improve at all?
I have been prescribed aropax for the last month now. I used, epilum, wellbutrin end efexor together in school. I am now 25 and since I have been on aropax I struggle sexually… I get turned on but my erection only lasts for 15 min at best… This is extremely embarrassing as I had no idea what was going on since this has never happened. I decided to dig abit deeper and now I know whats wrong… Im in my mid 20’s with an inability to “finish”! My girlfriend thinks its her and that she isnt sexy enough but I know what the problem is…. What do I do now???
I am in my 40’s and I was on Aropax for about 16 years. It destroyed any libido I had. My performance was good while I was on the drug but I had no libido. When I finally got off the drug I noticed that my libido stayed low and my performance was terrible. I am presently using Viagra and sometimes it works and sometimes it does not. I am desperate for answers to help with regaining my libido and sexual performance. Can any one help?
I had the same problem with Viagra. I now inject TriMex directly into my penis. How’s that for commitment?! It’s not as painful as it sounds after you get over the idea of it. My urologist taught me how to self-inject. It works 99% of the time. If I don’t inject the right spot, it doesn’t work. It’s relatively easy to do and stays erect until I climax. Sometimes we’ll over an hour.
I have lost myself and sexuality too. I want to sue them. Can we sue? Not that it will change anything for us but maybe it will stop them from harming others. I was never told this could happen and be permanent. It ruined my marriage and life.
Kathleen~Exactly what I was thinking. They need to be sued. Money is the only thing these drug industries understand. From reading the above posts, I am sickened by the amount of people whose lives have been ruined, but when I read about someone as young as 20 and has been permanently affected by the drug, I can’t believe there is no lawsuit happening now!
Nancy
You know why suing isn’t an option for most? Antidepressant Roulette. It’s purposeful the way these drugs are managed. Do you ever suspect it’s all a form of population control? I never used to be so paranoid but when you look at the huge number of people whose lives are being destroyed yet the push is to get as many people on treatment as possible all thw while siting lack of treatment as the problem… ? Unbelievable! Literally!
I started taking zoloft at 13 by the time I was 16 in highschool I was taking 300mg a day plus 10-20mg of ambien to “sleep”. I literally felt like a zombie 24/7 i’d “wake up”, go to school, weight train, football practice, “sleep”, and repeat. Life was in shades of grey. While I wasn’t sad I instead became more depressed in the sense that life was boring and pointless. I stopped going to school and practicing. Eventually after coming to a wall I decided I’d quit cold turkey or just die and get it over with. The withdrawal symptoms literally almost killed me. Chronic migraines, severe panic attacks, constant ringing in my ears, short term memory loss, hair loss, and complete loss of appetite. I went from 185 to 140 in three weeks due to the fact the only thing I could barely keep down was protein shakes.
After making it through I noticed I was still depressed but decided pumping chemicals that my body has not made itself is not the way to go. My insomnia has been better and worse at times since stopping. Some days I sleep like a brick, other days im up for 78hr looking like a skeleton. Honostly I can deal with both those now just because I learned I’m stronger than such negative emotions and wont let it get to me.<> Fear leads to anger. Anger leads to hate. Hate leads to suffering.
I took just two doses of Lexapro 10mg and it has already caused sexual dysfunction. I stopped taking the medication two days ago (and to hell with that warning about not stopping the medication abruptly). I read that the medication takes six days to leave your system, so I’m hoping it comes right in a few days.
Have you had improvement?
I took setraline for two days and immediately experienced the sexual dysfunction issues, inability to maintain an erection, delayed ejaculation and numbness. After a bit of research I found this site and stopped immediately. That was two weeks ago and nothing has changed. I’m very worried.
I started taking prozac when I was 18 after a visit to the psyche ward for depression. I was only on it for around 4 Mo the but in that time my penis shrunk quite a bit and lost all sensation. I’ve been impotent since and I’m now 21… I have a very hard time urinating due to how much my penis has shrunk , it no longer goes flaccid and is just a hard lump. My life is ruined, my doctors refuse to believe that this could have happened. Ive seen specialists, no one gives a FUCK! I also get very little reward from doing anything. I’m at my fucking wits end and tbh Im surprised I haven’t died from kidney failure because I can’t finish urinating and always feel like I have to go . If anyone ends up getting a law suit together I would hope I could be involved.
I had taken a number of SSRIs and SNRIs since my teen years and never had any problems with sexual dysfunction. In my early 30s, I tapered off paxil. In the midst of severe, debilitating withdrawal symptoms (nausea, vomiting, insomnia, suicidality, etc.), I experienced a huge surge in my sex drive. Then, nothing. It was like someone pulled the plug. That was 12 years ago, and my libido has never returned. I have told this story to countless doctors, but none believes the drug to be the cause. Why isn’t this problem more widely known?!
I did end up back on antidepressants, but I believe the damage is permanent and would not be remedied by stopping again. I can only hope that people considering going on SSRIs have this information before making a decision. I wish I had.
Hello everyone…ive been on seroxat for 7 months ive tapered of it barely managed the side effects and withdrawal effects…now 1 month of it i cant have 2 rounds with my girlfiend !!! i used to have 3 before….anxiety still here but im taking omega 3 supplements and im good now with it….only sensation and emotions are kinda dumb…Is there any cure or somethink ? shud i go back to porn ? used to be PMO addicted …maybe that will get some sex drive into me …oh im so sad…22 years old so young and cant enjoy my life …
where could I start? the feeling that I lost one of my sences and I had to live with it is the one overwhelming me now. And it is exactly described in the article. As if one lost the grace of his sight or his hearing sense, I think I reached a point that I should accept the fact I wpnt have any libido anymore.
Before : I used to enjoy sex life and had the capability to reach orgasm 2-3 times , each time 20-30 minutes. in the meantime I was suffering from depression that kept me moving forward. I started on Prozac for the following 2 years, during which I did not have any sexual relations. Rather, I met a girl whom I married later and that is when I found out I lost my libido. My doctor changed the medecine to Cymbalta , but same situation persists. Finally he changed to fluxetine, again no change. After 15 months of marriage, we barely had sex , and if any : it is without full desire, without passion and without ejaculation. I had to use performance enhancers like Viagra or Levetra, but they all help a man get an erection, and an erection without a desire , is just like any muscle in your body developing a crimp!
After stopping the medicine and this was since 5 months, no significant improvement, no libido , no desire , nothing moves me , and at 35 years old, my feeling toward sex is just like those at 80s! my life is being ruined, I am back depressed because of this and after thinking I would stay with my love forever, I feel I cannot continue this life , which is heart breaking for both of us.
Thanks for reading , and appreciate the graces of God before a time comes and they disappear,
I’ve felt the side-effects too, only after a few days and yes, it’s real. It is just unbelievable that this stuff (so-called antidepressants) can even be marketed. And a total black-out in the media with the web of lies and blame-the-victim mentality you get stuck in, when speaking up. I’m not even going to talk about the lack of ethics and rampant corruption in the medical profession, that this issue brings out. How can it be prescribed to children? How can it be prescribed to men, how can it be prescribed at all? I’m really grateful to this website for addressing this problem, seems to be the only one. Hope some lawsuits go out fast, that’s the only way to bring about some change and my heart goes out to all victims.
I just took my first dose of Lexapro today, and I’m really glad I’ve read these comments. I’m am going to seek alternative treatments.
I am 43 years old. My chest used to hurt. A cardiologist recommended a psychiatric clinic after numerous exams.
I consented because they suspected I was under stress from my tasks and responsibilities.
I started on fluvoxamine 10 mg after the psychiatric doctor verbally affirmed that the only side effects are nausea, insomnia, and stomach trouble.
I found my penis was non-responsive after a week, with a numbing sensation.
In a monthly appointment, my psychiatric doctor then opened that the drug had an adverse effect on this part but will go away with time. They adjusted my drug to Escitalopram 15mg, which is less sexually impacting. I trusted a doctor.
But things became worse when my wife noticed my penis was loose. I have no sensations or feelings.
My sexual pleasure has vanished.
Then I reached rxisk.org to learn about the side effects of these drugs.
In the third month, I complained to doctors about the side effects. But they refused to accept and accused me of blaming a drug sanctioned by the government.
After that appointment, I stopped taking it. I had the worst nightmare begin.
A month of terrible agony on both sides of my neck bones, a whoosh-whoosh sound, vertigo, and lightheadedness.
I’ve been off these drugs for 8 months.
But the harm is done. However, I regain my penis tightness but no longer generate semen, and my dry orgasm level decays a lot.
During these 8 months, I only felt sex with my partner once, but at last, I became a guy devoid of sexual pleasure.
Only recollections remain of a man who used to enjoy dry-less orgasms while masturbating 3 times a day and having sex twice weekly.
I regret taking such drugs without research.