SSRI & SNRI
SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin–norepinephrine reuptake inhibitors) are antidepressant medications that increase serotonergic signaling by inhibiting reuptake transporters (SSRIs primarily serotonin; SNRIs serotonin plus norepinephrine). Sexual side effects during treatment are well documented. A subset of individuals report that sexual symptoms persist after discontinuation, a phenomenon commonly referred to as post-SSRI sexual dysfunction (PSSD). Regulatory agencies have acknowledged reports of long-lasting sexual dysfunction continuing after stopping SSRIs/SNRIs, and some have updated safety communications to reflect this possibility.
Within PFS/PSSD/PAS discussions, SSRIs and SNRIs are typically raised not because they are considered anti-androgenic, but because they can strongly alter serotonin-driven neurochemistry and sexual function. Some individuals with PFS report symptom flares after exposure to serotonergic medications that feel subjectively similar to destabilization described in PSSD accounts. The overlap commonly cited is symptom-pattern similarity (sexual dysfunction, emotional blunting/anhedonia, altered arousal and stress response) and the idea that once sensitized, the nervous system may react unpredictably to serotonin-modulating agents. These interpretations remain hypotheses rather than established mechanisms, and high-quality prevalence or risk-prediction data are limited.
1) https://www.ncbi.nlm.nih.gov/books/NBK554406/
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC11450419/
Crash Anecdotes (Community Reports):
https://www.reddit.com/r/PSSD/
https://www.reddit.com/r/FinasterideSyndrome/comments/16203dj/antidepressants_opinions_lexapro/
How to Interpret This Page
This page summarizes anecdotal reports and community observations, not medical evidence. “Risk” here refers to how frequently severe or prolonged symptom worsening is reported, not to proven causation or population-wide probability. Individual responses vary widely, and absence of issues in some users does not rule out significant reactions in others.
Risk Signal Based on User Reports
Reports of Severe and Sometimes Lasting Worsening (for PFS/PSSD/PAS):
Among individuals who already have PFS/PSSD/PAS, SSRIs and SNRIs are frequently mentioned in community reports as preceding symptom worsening, sometimes described as prolonged. Concerns center on sexual dysfunction, emotional blunting, and broader nervous-system destabilization following serotonergic exposure. Because reported outcomes appear variable and, in some cases, severe, many in these communities consider avoidance or extreme caution a more conservative approach.
For individuals without these conditions, SSRIs and SNRIs are widely prescribed and beneficial for many, but there are still reports of persistent sexual and emotional side effects after discontinuation in a subset of users. Community discussions also note that reinstatement has been reported to help a minority of individuals with PSSD, though outcomes are inconsistent and this approach is generally viewed as high uncertainty and requiring careful medical oversight.
Evidence basis: Regulatory safety communications; clinical and review literature; anecdotal reports (online forums, self-reports); no controlled studies examining PFS/PSSD/PAS-specific outcomes.