Roy Whaley was 22 when his GP first offered to prescribe him antidepressants, but he resisted for almost a year.
At the time he was suffering from obsessive-compulsive disorder (OCD). ‘I had this intense anxiety around cleanliness and constantly needed to wash my hands,’ he says. ‘I actually wanted therapy and was put on the waiting list, but it was a long wait.’
After a very bad day when he crashed his car, he decided to give the antidepressants a try. ‘I was having a week where everything seemed to be going wrong,’ says Whaley, now 39 and living in Somerset. He started on the SSRI (selective serotonin reuptake inhibitor) citalopram, and although it made no impact on his OCD, he noticed almost immediately that something else was changing.
‘Before I took it, I was a normal young lad who felt horny all the time,’ he says. ‘Sex was on my mind constantly, and if I saw a naked woman, it would turn me on. Everything worked normally and when I had an orgasm, it was highly pleasurable.
‘When I took citalopram, my sex drive was wiped out. I stopped thinking about sex. If I had an orgasm, it was entirely pleasureless. The only analogy I can think of is when you have a cold and lose your sense of taste. You can still eat chocolate, but you can’t enjoy it. You go through the process, but feel nothing.’
For years, sexual dysfunction was an adverse effect of SSRIs that somehow slipped under the radar. Embarrassment and stigma stopped sufferers from coming forward – and many who did seek help were assured by their doctor that their symptoms were caused by depression and anxiety, not the medication.
This has slowly changed. Sexual dysfunction and the blunting of sexual responses 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 are suffering premature ejaculation. The drugs can cause inability to orgasm or pleasureless orgasm, genital numbness and loss of libido.
This can impact both women and men – although it is thought that men, who can also suffer erectile dysfunction as a symptom, might be more likely to report it and discontinue with the medication as a result.
The DJ and mental health campaigner 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 up and running’.
What’s now emerging is that, for some, 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 the Canadian government in 2021.
Research has found that PSSD can continue for years, even when mental health is otherwise fine and scores for depression or anxiety are normal. One study found cases of PSSD after just four days of taking the medication; in another, the PSSD had continued for 16 years (at the time of the study).
Research from Israel found that men who had discontinued SSRIs were three times more likely to require medication for erectile dysfunction subsequently than the general population. Last month, a group of scientists in the US joined together to sue the Food and Drug Administration for failing to warn patients of these potential persistent sexual side effects.
Roy Whaley: ‘It’s my duty to show what can happen’
Back in November 2007 when Whaley started on citalopram, he knew none of this. ‘To be honest, at first, I wasn’t even too bothered as I knew it was the drug – the effect was so immediate and dramatic that it was obvious. I just thought it would go away when I stopped taking it,’ he says.
Less than a month later, Roy did opt to stop taking it, partly because of this sexual side effect and also because it hadn’t eased his anxiety. About a month after that, his sex drive hadn’t returned to normal, so he went to his GP. ‘He told me that it couldn’t be the drug as it was all out of my system,’ he says. ‘As the months passed, I got more and more worried as 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 began reading accounts from people who’d had this for five or six years and still hadn’t recovered, and that is when I started to really worry,’ he says.
It was around this point that Whaley finally got to 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 it and instead convinced him to try the SSRIs again, which Whaley did for a few weeks before coming off.
‘If my libido was at 15 per cent of normal levels after taking SSRIs the first time, it had dropped to five per cent after the second,’ says Whaley. ‘It has never recovered.’
He has been in three short-lived relationships in the years since. ‘I didn’t tell my first girlfriend about it,’ he says.
‘I just sort of faked it, but the relationship eventually fizzled out.’ His subsequent relationships followed a similar pattern.
‘I did tell one girlfriend,’ he says, ‘but sex is very difficult to fake when you feel completely asexual. It’s almost like being an actor. I’m getting close to 40, my siblings and cousins have all had children and settled into long-term relationships. This has caused me absolute chaos.’
There is now an international support group for sufferers 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 on there who describe exactly the same experience,’ says Whaley. ‘There’s a lot of desperation among people on the PSSD Network.’
He is aware there are those who argue that talking about PSSD is irresponsible, as it might frighten off people who need the drugs for their mental health. However, he is adamant that in an era when SSRI prescriptions continue to soar (between 2015 and 2021, antidepressant prescriptions for children aged between five and 12 grew by 40 per cent), we should know the full facts, all the side effects and long-term risks.
There have been several suicides within the PSSD Network, including two last month. ‘Maybe my own case is severe, but I’ve met so many people in my normal life who have said that their sex drive has never been quite what it was since they took antidepressants,’ says Whaley.
This is why he is speaking out now – despite the embarrassment associated with the issue. ‘I feel like it’s my duty to show what can happen,’ he says. ‘I’ve had it so long and it’s not getting any better. I don’t feel I have much to lose.’