Post-SSRI sexual dysfunction: 532 survey respondents, 183 possible cases, 23 that met the strictest criteria
People from a PSSD forum described sexual problems that began on an SSRI or SNRI and did not resolve a month or more after stopping. Genital anaesthesia did not track with depression or anxiety. The design cannot estimate how common it is.
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: Recruited from a forum for people who believe they have PSSD, retrospective and self-reported; the authors state the design does not allow estimation of incidence. Only 23 of 532 met the strict criteria. Dose did not predict severity and depression did, so the illness remains part of the picture.
The first systematic attempt to characterise sexual side effects that outlast the drug, with its limits stated by its authors.
Significant findings
Ben-Sheetrit and colleagues start from the observation that sexual dysfunction emerging on SSRIs or SNRIs "persists in some patients beyond drug discontinuation," the condition called post-SSRI sexual dysfunction, PSSD. They invited members of a forum dedicated to PSSD to complete an online survey and sorted respondents into three tiers. Possible cases had normal sexual function before treatment, first experienced problems on a single SSRI or SNRI, and had not recovered a month or more after stopping, on the Arizona Sexual Experience Scale. High-probability cases were also under 50, free of confounding conditions, medications or drug use, and had normal anxiety and depression scores.
"Five hundred thirty two (532) subjects completed the survey, among which 183 possible cases were identified, including 23 high-probability cases."
What predicted severity: "Female sex, genital anesthesia, and depression predicted current sexual dysfunction severity, but dose/defined daily dose ratio and anxiety did not." And the finding the authors lean on: "Genital anesthesia did not correlate with depression or anxiety, but pleasureless orgasm was an independent predictor of both depression and case probability."
The conclusion: the findings "support the existence of PSSD, which may not be fully explained by alternative nonpharmacological factors related to sexual dysfunction, including depression and anxiety."
The other direction
The authors write the caveat themselves: "Limitations of the study include retrospective design and selection and report biases that do not allow generalization or estimation of incidence." Every respondent came from a forum for people who believe they have the condition, and reported their own history after the fact. Twenty-three of 532 met the strict criteria. Dose did not predict severity, which is not what a straightforward drug effect would usually show. Depression did predict severity, so the illness is still in the picture.
What this does not show
It cannot say how often PSSD happens, or prove that the drug caused it in any one person. It offers no treatment. It is not a reason to stop or avoid a drug; the persistence question is one to raise with a prescriber, with a timeline in hand.
Worth asking
If I develop sexual side effects on this drug, how would we tell them from the depression, and what is the plan if they do not stop when the drug does?
Source
Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship — Ben-Sheetrit J, Aizenberg D, Csoka AB, Weizman A, Hermesh H (2015)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1097/JCP.0000000000000300
DOI: 10.1097/JCP.0000000000000300
How this was scored
- Study design
- Cross-sectional study / survey
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- 532
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "early signal". Suggestive but preliminary. Not settled. It scores 43 out of 100 on our published rubric. One caveat travels with that badge: Recruited from a forum for people who believe they have PSSD, retrospective and self-reported; the authors state the design does not allow estimation of incidence. Only 23 of 532 met the strict criteria. Dose did not predict severity and depression did, so the illness remains part of the picture. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship — Ben-Sheetrit J, Aizenberg D, Csoka AB, Weizman A, Hermesh H (2015). Published in: Reputable peer-reviewed journal. DOI: 10.1097/JCP.0000000000000300. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cross-sectional study / survey. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.