Roy Whaley was 22 when his GP first offered to prescribe him antidepressants, but he resisted for almost a year.
At the time, she suffered from obsessive-compulsive disorder (OCD). “I had intense anxiety around cleanliness and needed to wash my hands constantly,” she says. “I actually wanted to go to therapy and was put on a waiting list, but it was a long wait.”
After a very bad day when she crashed her car, she decided to try antidepressants. “I was having a week where everything seemed to be going wrong,” says Whaley, now 39 and living in Somerset. She started taking the SSRI (selective serotonin reuptake inhibitor) citalopram and, although it had no effect on her OCD, she noticed almost immediately that something else was changing.
“Before I took it, I was a normal young man who felt horny all the time,” he says. “Sex was on my mind constantly, and if I saw a naked woman, I would get turned on. Everything worked normally and when I had an orgasm, it was very pleasurable.
“When I took citalopram, my sex drive disappeared. I stopped thinking about sex. If I had an orgasm, I didn’t feel any pleasure. The only analogy I can think of is when you have a cold and you lose your sense of taste. You can still eat chocolate, but you can’t enjoy it. You go through the process, but you don’t feel anything.”
For years, sexual dysfunction was a side effect of SSRIs that somehow went unnoticed. Shame and stigma prevented those affected from coming forward to report it, and many who did seek help were reassured by their doctor that their symptoms were due to depression and anxiety, not the medication.
This has slowly been changing. Sexual dysfunction and blunted sexual responses have become a well-documented side effect of several classes of serotonergic antidepressants (antidepressants that act on the neurotransmitter serotonin), including SSRIs. For this reason, they have even been prescribed to help men who suffer from premature ejaculation. These drugs can cause an inability to achieve orgasm or an orgasm without pleasure, genital numbness, and loss of libido.
This can affect both women and men, although it is thought that men, who can also experience erectile dysfunction as a symptom, may be more likely to report it and stop taking the medication as a result.
DJ and mental health activist Roman Kemp recently made headlines when he described how SSRIs reduced his libido, although for him, the problem was easily solved by switching to an alternative SSRI which, he says, got him “back on track”.
What is now being discovered is that in some people, sexual dysfunction persists even when they have stopped taking the drug. This is a condition known as post-SSRI sexual dysfunction (PSSD), which was officially recognised by the European Medicines Agency in 2019 and by the Canadian government in 2021.
Research has shown that PTSD can continue for years, even when mental health is good and depression or anxiety levels are normal. One study found cases of PTSD after just four days of taking medication; in another, the disorder had continued for 16 years (at the time of the study).
Research in Israel found that men who stopped taking SSRIs were three times more likely to need erectile dysfunction medication later than the general population. Last month, a group of U.S. scientists banded together to sue the Food and Drug Administration for failing to warn patients about these potential lingering sexual side effects.
Roy Whaley: “It is my duty to show what can happen”
In November 2007, when Whaley started taking citalopram, he didn’t know any of this. “To be honest, I wasn’t even too worried at first because I knew it was the drug – the effect was so immediate and dramatic that it was obvious. I thought it would go away when I stopped taking it,” he says.
Less than a month later, Roy decided to stop taking it, partly because of this sexual side effect and also because it hadn’t helped his anxiety. About a month later, his sex drive hadn’t returned to normal, so he went to see his GP. “He told me it couldn’t be the drug, as I’d completely eliminated it from my system,” he says. “As the months went by, I became increasingly worried because nothing seemed to improve.”
Whaley began doing some research on her own and found people on some online forums who were experiencing the same thing. Today, the PSSD Reddit forum has 13,000 members. “I started reading accounts of people who had had this for five or six years and still hadn’t recovered, and that’s when I started to really worry,” she says.
It was at this point that Whaley finally reached the top of the waiting list to see a psychiatrist for his OCD. When he mentioned his sexual dysfunction at his first appointment, the psychiatrist dismissed him and instead convinced him to try SSRIs again, which Whaley did for a few weeks before stopping taking them.
“Where my libido was at 15 percent of normal levels after taking SSRIs the first time, it was down to 5 percent after the second,” Whaley says. “It never recovered.”
Since then he has had three short-term relationships. “I didn’t tell my first girlfriend,” he says.
“I faked it, but the relationship ended up failing.” Her subsequent relationships followed a similar pattern.
“I told a friend,” she says, “but it’s really hard to fake sex when you feel completely asexual. It’s almost like being an actor. I’m approaching 40, my siblings and cousins have all had kids and settled into long-term relationships. It’s caused me absolute chaos.”
There is currently an international support group for patients called the PSSD Network (pssdnetwork.org), which has helped Whaley. A year ago, the site had 7,000 monthly visitors; now it’s 50,000. “I’ve met people there who describe exactly the same experience,” Whaley says. “There’s a lot of desperation among people in the PSSD network.”
She is aware that there are those who argue that talking about PSSD is irresponsible, as it could scare people who need the drugs for their mental health. However, she is adamant that in an era when SSRI prescriptions continue to rise (between 2015 and 2021, antidepressant prescriptions for children aged between five and 12 rose by 40 per cent), we should know all the facts, all the side effects and the long-term risks.
There have been several suicides on the PSSD network, including two in the past month. “My case may be severe, but I’ve met plenty of people in my normal life who have said their sex drive has never been what it was since they started taking antidepressants,” Whaley says.
That’s why she’s speaking out now, despite the shame she feels about the matter. “I feel it’s my duty to show what can happen,” she says. “I’ve been like this for a long time now and it’s not getting better. I don’t feel like I have much to lose.”
