What is PSSD?
Post-SSRI sexual dysfunction
Post-SSRI sexual dysfunction (PSSD) is a poorly understood and understudied medical condition that involves persistent symptoms of genital numbness and sexual dysfunction following an exposure to, and withdrawal from, a psychiatric medication such as (but not limited to) an SSRI or SNRI (Bala et al. 2018). In addition, PSSD patients frequently report experiencing additional symptoms such as emotional blunting, cognitive impairment and anhedonia. Reports also indicate that the syndrome may be seen as a spectrum where patients’ symptoms vary in presentation and can range from mild to severely debilitating.
While PSSD was first reported in the medical literature in 2006 (Reisman 2020), its underlying causal mechanisms remain largely unknown.
Most research up to this point has been focused on investigating neurosteroid and gut microbiome alterations after SSRI withdrawal in animal models such as seen in prof. Melcangi’s work (Giatti et al. 2024b).
An accurate prevalence rate for PSSD has currently not been established yet.
Despite its name and definition referring to SSRI and SNRI medications, patients have reported getting PSSD from all kinds of pharmaceuticals, ranging from SSRIs like Escitalopram (Lexapro), SNRI’s like Venlafaxine (Effexor), NDRI’s like Bupropion (Wellbutrin), TCA’s (tricyclic antidepressants like Amitriptyline) and even atypical antidepressants such as Mirtazapine (Remeron). Additionally, many have also reported acquiring identical syndromes after having used other psychotropic drug classes, such as antipsychotics like Olanzapine (Community survey).
Core symptoms of PSSD
• Genital numbness
• Sexual dysfunction
• Emotional blunting
• Anhedonia
• Cognitive impairment