Roy Whaley was 22 when his doctor first offered him antidepressants, but he refused them for almost a year.
At the time, he was suffering from obsessive-compulsive disorder (OCD). “I had an intense fear of cleanliness and had to wash my hands constantly,” he says. “I actually wanted therapy and was put on the waiting list, but the wait was long.”
After a particularly bad day, when he crashed his car, he decided to try antidepressants. “I had a week where everything seemed to go wrong,” says Whaley, now 39 and living in Somerset. He started taking the selective serotonin reuptake inhibitor (SSRI) citalopram, and although it had no effect on his OCD, he noticed something else changing almost immediately.
“Before I took it, I was a normal young man who felt horny all the time,” he says. “Sex was constantly on my mind and when I saw a naked woman I got excited. Everything worked normally and when I had an orgasm it was very pleasurable.
‘When I took citalopram, my sex drive was gone. I didn’t think about sex anymore. When I had an orgasm, it was completely pleasureless. The only comparison 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 flew under the radar. Shame and stigma kept patients from coming forward—and many who did seek help were assured by their doctors that their symptoms were caused by depression and anxiety, not the medication.
This has slowly changed. Sexual dysfunction and blunting of sexual response has 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. The drugs can lead to inability to have an orgasm or orgasm without pleasure, genital numbness, and loss of libido.
This can affect both women and men, although it is thought that men, who may also experience erectile dysfunction as a symptom, are more likely to report this and stop taking the medication as a result.
DJ and mental health campaigner Roman Kemp recently made headlines when he described how SSRIs reduced his libido. For him, however, the problem was easily solved by switching to an alternative SSRI, which, he says, “got him back on his feet”.
What is now emerging is that sexual dysfunction persists for some even after they have stopped taking the drug. This is a condition known as post-SSRI sexual dysfunction (PSSD), which was officially recognized by the European Medicines Agency in 2019 and the Canadian government in 2021.
Research has shown that PSSD can persist for years, even when mental health is otherwise good and depression or anxiety scores are normal. One study found cases of PSSD after just four days of taking the medication; in another study, PSSD lasted 16 years (at the time of the study).
Research from Israel found that men who stopped taking SSRIs were three times more likely to need erectile dysfunction medication afterward than the general population. Last month, a group of scientists in the U.S. joined forces to sue the Food and Drug Administration for failing to warn patients about these potential lingering sexual side effects.
Roy Whaley: ‘It’s my duty to show what can happen’
When Whaley started taking citalopram in November 2007, he knew nothing about it. ‘To be honest, I didn’t really care at first because I knew it was the drug – the effect was so immediate and dramatic that it was obvious. I just thought that if I stopped taking it, it would go away,’ he says.
Less than a month later, Roy decided to stop taking it, partly because of this sexual side effect and also because it didn’t relieve his anxiety. About a month later, his sex drive still wasn’t back to normal, so he went to his doctor. “He told me it couldn’t be the drug because it was all out of my system,” he says. “As the months went by, I became more and more concerned because nothing seemed to get better.”
Whaley began doing his own research and found people on a few online forums who were experiencing the same thing—today, the PSSD Reddit forum has 13,000 members. “I started reading stories of people who had had this for five or six years and still hadn’t recovered, and that’s when I really started to worry,” he says.
It was around this point that Whaley finally found himself at 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 brushed it off and instead convinced him to try the SSRIs again, which Whaley did for a few weeks before stopping them.
“If my libido was 15 percent of normal the first time I took SSRIs, it was down to five percent the second time,” Whaley says. “It never recovered.”
Since then, he has had three short-lived relationships. “I didn’t tell my first girlfriend,” he says.
‘I pretended, but the relationship eventually fell apart.’ His subsequent relationships followed a similar pattern.
“I’ve told a friend,” he says, “but sex is really hard to fake when you’re completely asexual. It’s almost like being an actor. I’m nearly 40, and my siblings and cousins have all had kids and ended up in long-term relationships. It’s caused me absolute chaos.”
There is now 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 visits; now it’s 50,000. “I’ve met people who describe the exact same experience,” Whaley says. “There’s a lot of desperation among people on the PSSD Network.”
He knows that there are those who argue that talking about PSSD is irresponsible because it could scare off people who need the drugs for their mental health. But he is adamant that in an era where SSRI prescriptions continue to rise (between 2015 and 2021, antidepressant prescriptions for children aged five to 12 grew by 40 percent), we need to know the full facts, all the side effects and long-term risks.
There have been multiple suicides within the PSSD network, including two last month. “Maybe my own case is serious, but I’ve met so many people in my normal life who said their sexual desires have never been the same since they started taking antidepressants,” Whaley says.
That’s why he’s speaking out now — despite the shame that comes with the issue. “I feel like it’s my duty to show what can happen,” he says. “I’ve had it for so long and it’s not getting better. I don’t feel like I have much to lose.”