SSRI & SNRI
SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin–norepinephrine reuptake inhibitors) are antidepressants that increase serotonergic signaling by inhibiting reuptake transporters (SSRIs mainly serotonin; SNRIs serotonin + norepinephrine) (1). Sexual side effects during treatment are well-known, and a subset of people report that sexual symptoms persist after stopping—a condition commonly referred to as PSSD (post-SSRI sexual dysfunction). Regulators have acknowledged reports of long-lasting sexual dysfunction continuing despite discontinuation of SSRIs/SNRIs, and some agencies have updated safety communications accordingly (2).
In PFS communities, SSRIs/SNRIs are often discussed not because they’re “anti-androgenic” (they generally aren’t framed that way), but because they can strongly shift serotonin-driven neurochemistry and sexual function, and some people with PFS report flares/crashes after serotonergic drugs that feel similar to the destabilization described in PSSD accounts. The overlap people point to is mainly symptom-pattern overlap (sexual dysfunction, emotional blunting/anhedonia, altered arousal) and the idea that once sensitized, the nervous system may react unpredictably to serotonin-modulating agents—even though mechanisms remain uncertain and high-quality prevalence data are limited (3).
1) https://www.ncbi.nlm.nih.gov/books/NBK554406/
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC11450419/
Crash Anecdotes:
https://www.reddit.com/r/PSSD/
https://www.reddit.com/r/FinasterideSyndrome/comments/16203dj/antidepressants_opinions_lexapro/
My Personal Risk Ranking:
Extreme Risk of Permanent Worsening (for PFS/PSSD/PAS):
If you currently have PFS/PSSD/PAS, these substances may carry an extreme risk of worsening symptoms—potentially in a lasting way—and is best avoided. It is important to note there are anecdotes of reinstatement helping a minority in the PPSD forum, but this should be approached with extreme caution.