Antidepressants can trigger sexual problems, drug watchdogs warn – pill boxes updated with new safety alert

Antidepressants will carry stronger warnings about suicidal thoughts and long-lasting sexual side effects under new safety measures announced today.  

Health chiefs today announced that patient information leaflets will be updated to make the risks more prominent, through the use of boxed warnings and clearer signposting to support services.

Patients will also be warned that some antidepressants can cause serious sexual problems that may continue long after treatment has stopped. 

Symptoms can include genital numbness, a complete loss of libido, erectile dysfunctions, difficulties orgasming, vaginal dryness and low mood. 

The condition, known as Post SSRI Sexual Dysfunction (or PSSD), has been disputed for years – with some doctors questioning whether persistent sexual problems are caused by the drugs or underlying mental health conditions. 

Now, for the first time, regulators have explicitly acknowledged that sexual dysfunction linked to antidepressants can persist after patients come off the drugs.

The move follows an extensive review by the Commission on Human Medicines, prompted by concerns raised by patients and families about how the risks of antidepressants are communicated. 

‘Patients need clear and accessible information about the benefits and risks of medicines so they can make informed decisions,’ Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency (MHRA) said.

‘Antidepressants are effective medicines for the treatment of depression and other conditions. When used appropriately and under clinical supervision, for the vast majority of individuals, the benefits outweigh the risks. 

‘The aim is not to discourage use, but to improve the prominence and clarity of the existing warnings.’

The updated guidance also advises healthcare professionals to discuss the risk of suicidal thoughts and behaviours when starting antidepressants or changing doses.

The warning comes amid growing attention on PSDD, with one in seven adults now thought to be taking antidepressants.  

Mental health disorders including depression and anxiety can reduce libido, while the medications can also dampen sexual function. For most patients, these problems improve after the drug is stopped or the dose is reduced.

PSSD is used to describe cases where sexual symptoms persist for months or even years after people stop taking SSRIs. Some patients report symptoms that they believe are permanent.

The MHRA has now said there is evidence some antidepressants – including duloxetine, fluvoxamine, fluoxetine – are associated with sexual dysfunction and that symptoms can continue after treatment is stopped. 

Antidepressants work by blocking the reabsorption of serotonin in the brain, to help regulate mood and emotion.

While sexual side effects and warnings about suicidal thoughts are not new, regulators have now strengthened the wording to ensure patients are more clearly informed of the potential risks.

Patients already taking antidepressants will receive the updated leaflets when they become available in 2027.

The MHRA stressed that anyone taking antidepressants should not stop treatment suddenly and should speak to a healthcare professional before making any changes to their medication.