Research from the University of Copenhagen has revealed that a simple brain scan may help identify individuals at risk of experiencing sexual dysfunction due to antidepressants. This study is particularly significant as selective serotonin reuptake inhibitors (SSRIs), prescribed to millions in the UK annually, often lead to side effects such as diminished libido, erectile dysfunction, and difficulties with orgasm.
The study involved 90 participants aged between 18 and 56 diagnosed with major depressive disorder but not currently on medication. Among them, 66 were women and 24 were men. Participants underwent an electroencephalogram (EEG) to measure serotonin levels before starting treatment with escitalopram, known as Cipralex in the UK, over an eight-week period. Researchers evaluated their sexual function both prior to and after the treatment.
In their findings, published in the Journal of Psychiatric Research, the researchers noted that sexual side effects are prevalent, occurring in approximately 40–70% of patients treated with SSRIs. The report emphasized that these side effects can severely impact self-esteem and quality of life, potentially leading to medication non-adherence.
After eight weeks of treatment, those with higher initial serotonin levels were more likely to report sexual dysfunction, particularly issues with achieving orgasm. Approximately 65% of participants indicated some form of sexual problem linked to the medication, with 39% describing these issues as serious and distressing. Clinicians observed that 47% of patients experienced sexual side effects due to escitalopram, with 17% reporting severe complications.
The researchers advocate for this study to reshape how healthcare providers approach treatment for depression. They suggest that measuring serotonin levels could better inform prescribing practices. However, they acknowledged limitations in their study, such as the higher prevalence of pre-existing sexual dysfunction in women compared to men, and the disproportionate representation of female participants.
There has been a rising discourse surrounding post-SSRI sexual dysfunction (PSSD), a controversial condition that remains unrecognized by the National Health Service (NHS). Proponents of PSSD claim that they suffer from long-lasting sexual issues following cessation of SSRIs, prompting calls for greater recognition and research into this phenomenon. A review by European Psychiatry highlights “growing evidence” for the existence of PSSD, although research is limited.
An early study published in the Annals of General Psychiatry estimated that one in 216 patients experiences erectile dysfunction after stopping SSRIs. The PSSD Network reports common complaints such as genital numbness, erectile dysfunction, vaginal dryness, and a complete loss of libido.
The NHS acknowledges that sexual side effects can occur while taking SSRIs. Recent data indicates that 286,799 individuals aged five to 19 were prescribed antidepressants in 2024, a notable increase from 242,629 in 2016. Common SSRIs include citalopram, fluoxetine, and sertraline, marketed under brand names such as Cipramil, Prozac, and Lustral.
As the conversation around SSRIs and sexual health continues to evolve, this research underscores the importance of personalized treatment strategies and the need for further investigation into the long-term effects of these medications on sexual function.
