A recent study reveals that a simple brain scan may help identify individuals at risk of experiencing sexual dysfunction from commonly prescribed antidepressants. Researchers from the University of Copenhagen focused on patients taking selective serotonin reuptake inhibitors (SSRIs), a class of medications that includes escitalopram, known commercially as Cipralex in the UK. These drugs, prescribed to millions annually, are often linked to side effects such as decreased libido, erectile dysfunction, and difficulties with orgasm.
The study involved 90 participants aged 18 to 56, all diagnosed with major depressive disorder but not currently on medication. Of these, 66 were women and 24 were men. Prior to beginning an eight-week regimen of escitalopram, the subjects underwent an electroencephalogram (EEG) to measure serotonin levels in their brains. Researchers assessed sexual function at both the start and conclusion of the treatment period.
According to the findings published in the Journal of Psychiatric Research, sexual side effects are prevalent among SSRI users, affecting between 40 and 70 percent of patients. The report noted that these issues can significantly impact self-esteem and relationships, leading some individuals to discontinue their medication.
At the end of the eight weeks, the team observed that participants with higher baseline serotonin levels were more likely to experience sexual side effects, particularly difficulties in achieving orgasm. Approximately 65 percent of those surveyed reported sexual problems they attributed to the medication, with 39 percent describing these issues as distressing. Clinicians found that 47 percent of patients experienced sexual side effects due to the SSRI treatment, and 17 percent reported severe and distressing symptoms.
As sexual function declined across the cohort by nearly 23 percent, the researchers hope their results will prompt healthcare providers to consider serotonin levels when prescribing SSRIs. However, they acknowledged limitations in their study, including the pre-existing sexual dysfunction that some women experience prior to treatment.
There is a growing conversation around post-SSRI sexual dysfunction (PSSD), a condition that remains controversial and is not currently recognized by the National Health Service (NHS). Some individuals claim to suffer long-term sexual issues even after discontinuing SSRIs, leading to calls for further investigation into the lasting impacts of these medications. A review published in European Psychiatry has indicated that there is “growing evidence” supporting the existence of PSSD, even with limited research on the subject.
An earlier study published in the Annals of General Psychiatry estimated that approximately 1 in 216 patients experienced erectile dysfunction post-SSRI use. Common complaints associated with PSSD include genital numbness, vaginal dryness, and a total loss of libido.
In light of these findings, the NHS confirmed that sexual side effects are acknowledged among users of SSRIs, with 286,799 people aged five to 19 prescribed antidepressants in 2024, compared to 242,629 in 2016. SSRIs, such as citalopram, fluoxetine, and sertraline, known by brand names like Cipramil, Prozac, and Lustral, have become a critical component of treatment for many struggling with depression.
This new research underlines the importance of personalized treatment in mental health care, emphasizing the need for a more nuanced understanding of how antidepressants can affect sexual health and overall quality of life.
