Andy Wilson has no doubt that a four-month course of antidepressants he took 13 years ago ruined his sex life, leaving him with no sexual feeling at all.
‘My life was destroyed by a drug that a doctor prescribed after a ten-minute conversation, without offering me any warning of the potentially devastating side-effects,’ says the 37-year-old from Dumbarton, Scotland.
Andy suffers from a condition called PSSD (post-SSRI sexual dysfunction), which has left him virtually impotent.
This is a recognised, long-term adverse effect caused by SSRIs (selective serotonin reuptake inhibitors, a widely prescribed group of antidepressants that includes citalopram).
But cases of persistent sexual dysfunction have also been reported following the use of other drugs, including older antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants – as well as antihistamines, tetracycline antibiotics (such as doxycycline), and prescription painkillers (opioids such as tramadol).
PSSD is characterised by genital numbness, pleasureless or weak orgasm, loss of libido – and, in men, erectile dysfunction.
‘I think when people hear the term PSSD they think it’s about not being able to get an erection, yet everything else is normal,’ says Andy.
‘In my case at least, this is totally wrong.
Andy Wilson has no doubt that a four-month course of antidepressants he took 13 years ago ruined his sex life, leaving him with no sexual feeling at all
‘Sexual dysfunction is only one small part of this SSRI damage. It affects every single aspect of my life.
‘I’ve not had a full-time job or had any relationships or sex in the last 13 years and I feel like I’m constantly behind glass and can’t make a connection with another person.’
Andy contacted me recently through the website antidepressantrisks.org, which I set up in 2021 after I suffered a life-threatening reaction to antidepressants.
He is just one of hundreds to get in touch with problems ranging from withdrawal symptoms to suicidal thoughts.
Over the past decade, antidepressant prescriptions have almost doubled in England alone, rising from 47.3 million in 2011 to 86.6 million in 2022/23, with over 8.6 million adults now prescribed them annually (nearly 20 per cent of adults), according to the NHS Business Services Authority.
While it’s important to acknowledge that many benefit from these drugs, Andy is speaking out now to warn people of the potential hidden dangers.
His story began when he was 23, and studying TV production at Glasgow Metropolitan College.
‘I was a completely healthy young man,’ he says.
Andy contacted me through the website antidepressantrisks.org, which I set up in 2021 after I suffered a life-threatening reaction to antidepressants, writes Katinka Blackford Newman
‘My problems started when I got anxious over some essays and projects I had to do for my course. I felt uncertain about my ability to do them so I kept on procrastinating and playing games on my computer. There were about five different assignments and I couldn’t start any of them because I felt paralysed with anxiety.’
Eventually Andy dropped out of his course. He says: ‘I had missed all these deadlines, so I packed it in. I felt hopeless – if I couldn’t do a simple essay then how would I ever achieve anything in my life?’
Andy went to his GP in the hope he would be referred for therapy, but instead was prescribed citalopram for anxiety and depression.
‘I was reluctant to take a drug because I knew my problems were psychological,’ he says.
‘I asked the doctor lots of questions and I remember he specifically told me not to read up about the side-effects in the leaflet because it would scare me.
‘Looking back, even if I’d read the leaflet, it never would have sufficiently warned me of what was to come.’
Andy continues: ‘I trusted my doctor and more importantly I trusted medicine. I figured if all these smart people who publish in medical journals, write guidelines and work for the regulators are telling me the best evidence says I should take this drug, then I should do it.’
Just a few days after taking the first few 10mg tablets, Andy started to experience nausea and dizziness, and his mind began to race.
He also developed four mouth ulcers – ‘very unusual for me as before this I would get roughly one mouth ulcer per year’.
‘I also had a very high sex drive for the first week. I went back to my doctor and told him about these side-effects and he said it couldn’t be anything to do with the drug.’
(In fact, high sex drive is listed on the patient leaflet as a possible effect; ulcers have also been reported and written about, including in a research paper – possibly caused by dry mouth, another listed side effect.)
After a couple of months these side-effects had gone, but Andy wasn’t feeling any benefit in terms of his mental wellbeing.
‘By now I’d dropped out of college and was living with my parents,’ he recalls.
‘I still felt anxious and depressed about the future. As there was no improvement to my mood, four weeks after starting the drug I went back to my doctor. He told me to double the dose to 20mg.
‘After just two days I started to get impulsive suicidal thoughts. I’d never experienced anything like this before and it was terrifying.
‘It was as if someone was implanting thoughts in my brain. I also had other symptoms – diarrhoea, insomnia and a fever – so I was in no doubt that the drug was messing with my mind and body.’
After two days at the higher dose, Andy decided to go back down to 10mg and while the severe suicidal thoughts went away, he still wasn’t noticing any improvement in his mood – so after being on the drugs for four months, he decided to stop.
‘I didn’t want to be taking the citalopram long term for no reason, so I spoke with my doctor and he told me I could either quit cold turkey as I was on a low dose or, if I wanted to be cautious, to cut the pills in half for a week or two which is what I decided to do.’
To Andy’s horror, after cutting down and then quitting, he was hit with a number of symptoms he’d never experienced before.
‘Within a few days I knew something was wrong,’ he says.
‘One of the first things I noticed was that my genitals went numb. I could still feel touch, but I had zero erogenous sensation in my penis. My libido was completely erased.
‘Before taking the drug, I loved women. Now, looking at a naked woman, I felt no desire whatsoever.
‘I was unable to orgasm, or at best they were severely muted and I barely felt any pleasure.
‘My erections were much weaker and I had very weak ejaculations. I basically had complete sexual dysfunction as a 23-year-old man.’
In 2019 the European Medicines Agency formally recognised the existence of PSSD, announcing new recommendations that all SSRI and SNRI antidepressants should carry warnings about the risk of long-term sexual dysfunction.
Despite this there has been little research into the condition or its exact cause.
As Joanna Moncrieff, a professor of critical and social psychiatry at University College London, explains: ‘Serotonin, the brain chemical which is thought to regulate mood, appears to be bad for some people’s sex life.
‘Animals studies show that drugs designed to boost the brain chemical serotonin impair sexual function, and they demonstrate that these effects can persist after the drugs are stopped.
‘This suggests that antidepressants change the body in ways that are difficult for the body to reverse.’
It wasn’t just Andy’s sexual functioning that was affected after he stopped taking citalopram.
‘For the first year I had zero appetite and lots of digestion issues,’ he says.
‘Every two months or so I also suffered nausea and vomiting, and sometimes I had to pee 20 times a day. I had body temperature issues – sometimes I would be burning up and have a mild fever and other times I’d be shivering. I had frequent headaches, dizziness and weird tingling sensations in my brain.’
Andy went online and found a community of people describing similar symptoms on coming off their antidepressants.
‘A lot of them said their doctors just dismissed them,’ he says.
‘They told them that withdrawal effects only last two weeks and that the drug is out of your system so it can’t be causing any of these effects.
‘I didn’t go back to my doctor because I knew he wouldn’t believe me as he was so dismissive at the start.’
Other withdrawal symptoms patients report include emotional numbing, depersonalisation (a feeling of being disconnected from yourself, as though you’re watching your life from the outside) and other sensory problems involving skin, smell or vision.
Andy, too, had episodes of depersonalisation, anxiety, paranoia and nightmares, he says.
‘My mood was volatile, sometimes I’d be depressed and crying and other days I’d feel ok.
‘Before taking citalopram, although I anxious about my course work, I didn’t have any serious mental health problems. I had never experienced any of these things before in my life.’
He adds: ‘Another problem that began after I stopped the citalopram was brain fog, and a lack of motivation, energy and drive.
‘I felt pressure in my head as if someone was squeezing on my temples and I needed to lie down to wait for it to pass.
‘Before taking these drugs, I’d get ideas popping in my head and I’d be motivated to do things. Now my mind is blank all the time.
‘I became incredibly socially withdrawn. My mind used to be filled with jokes and I could tell stories, but I now struggle to make eye contact and I don’t smile or laugh nearly as often.’
He says he’s not had any friends for over a decade.
After ten years of suffering these symptoms, in a desperate attempt to feel better, he reinstated the citalopram at a very low dose of 0.1mg – some patient support forums suggest that if you have come off a drug too quickly, re-introducing it can stabilise you.
Andy did this by diluting the tablets in water, but says after four weeks his symptoms had only got worse.
‘I started getting impulsive suicidal thoughts again, so I quit and tried to ride out the withdrawal,’ he says.
Thirteen years since Andy first took the citalopram, he suffers from the same debilitating symptoms that he experienced immediately after coming off it.
‘The impact on my life has been catastrophic,’ he says.
‘I don’t even want friends because I don’t enjoy socialising any more. When you can’t make a connection with another person, then you can never even get to a point where sex is a possibility.
‘But actually I don’t even care about sex. If I had to live with sexual dysfunction for the rest of my life, but I could make connections with other people again, think clearly and be like my old self, I would take that deal in a heartbeat.’
Professor Moncrieff is a prominent critic of what she and other experts describe as the over-prescribing of antidepressants.
She also feels patients are not being properly warned about their potential harms.
As she told the Mail: ‘Antidepressants are well-known to cause sexual dysfunction while people are taking them but now there is evidence that this may continue after people stop. In some cases, the drugs seem to disrupt sexual function for years.
‘The most important thing is that we warn people of this potential side-effect so that when they are offered antidepressants they can make a properly informed decision,’ she says.
‘Antidepressants have been treated as if they are relatively harmless, but they’re not.’
Like other PSSD sufferers, Andy has no idea how long his condition will last.
His dreams of becoming a computer programmer have been put on hold and now he can only manage a part-time job in a supermarket for ten hours per week. The rest of the time he spends in his room. He still lives at home.
‘My parents have been fantastic,’ he says. ‘They thought this was just a phase and that I would get better but this has been going on for 13 years now.
‘I’m 37 and it feels like my whole life has been taken away.
‘I feel like part of my personality was erased, that I’m now half a person. It’s like a part of me died back then and I’m a ghost of what I used to be.’
- Katinka Blackford Newman is author of The Pill That Steals Lives (John Blake)
