Characteristics and risk factors of Post SSRI Sexual Dysfunction (PSSD)

Background Post-SSRI Sexual Dysfunction (PSSD) is a persistent, iatrogenic condition characterised by sexual and sensory impairments following the use of serotonergic antidepressants. Despite increasing patient reports, PSSD remains underdiagnosed and poorly understood. Objective This study aimed to identify clinical and demographic characteristics of individuals experiencing PSSD and explore potential risk factors, including medication history, substance use, stress, and lifestyle. The focus was also placed on the characterisation of individual symptoms and the specificity of substances capable of causing PSSD or alleviating its effects after the condition has developed. Methods An anonymous online survey was conducted in the first half of 2024, including 76 valid responses from individuals reporting persistent sexual dysfunction after discontinuing antidepressants from all over the world. The questionnaire assessed symptoms across four distinct life periods (pre-diagnosis, pre-treatment, during treatment, post-treatment) and included items from validated psychiatric and sexual function scales. Results Most participants had taken SSRIs, with variable treatment durations. Sexual life satisfaction significantly decreased after psychiatric treatment compared to both during treatment and the pre-psychiatric symptom period. No associations were found with treatment duration, substance use, obesity, physical activity, somatic comorbidities, or emotional reactivity. Negative feelings correlated with lower overall sexual satisfaction. Symptoms ranged from genital anaesthesia to emotional blunting and cognitive dysfunction. Only a minority had received formal diagnoses. Conclusion PSSD significantly threatens quality of life and demands greater clinical awareness. Further research is essential to define diagnostic criteria, understand underlying mechanisms, and develop effective interventions.