Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

Author:

Healy David1,Bahrick Audrey2,Bak Maarten34,Barbato Angelo5,Calabrò Rocco Salvatore6,Chubak Barbara M.7,Cosci Fiammetta388,Csoka Antonei B.9,D’Avanzo Barbara5,Diviccaro Silvia10,Giatti Silvia10,Goldstein Irwin1112,Graf Heiko13,Hellstrom Wayne J.G.14,Irwig Michael S.1516,Jannini Emmanuele A.17,Janssen Paddy K.C.1819,Khera Mohit20,Kumar Manoj Therayil21,Le Noury Joanna22,Lew-Starowicz Michał23,Linden David E.J.3,Lüning Celine24,Mangin Dee1,Melcangi Roberto Cosimo10,Rodríguez Omar Walid Muquebil Ali Al Shaban25,Panicker Jalesh N.2627,Patacchini Arianna8,Pearlman Amy M.28,Pukall Caroline F.29,Raj Sanjana30,Reisman Yacov31,Rubin Rachel S.32,Schreiber Rudy3,Shipko Stuart33,Vašečková Barbora34,Waraich Ahad12

Affiliation:

1. , McMaster University, , , Canada

2. , University of Iowa, , , USA

3. , Maastricht University, , The Netherlands

4. , Mondriaan Mental Health, , The Netherlands

5. , IRCCS Istituto di Ricerche Farmacologiche Mario Negri, , Italy

6. IRCCS Centro Neurolesi Bonino-Pulejo, , Italy

7. , Icahn School of Medicine at Mount Sinai, , , USA

8. , University of Florence, , Italy

9. , Howard University College of Medicine, , , USA

10. , University of Milan, , Italy

11. Alvarado Hospital, , , USA

12. San Diego Sexual Medicine, , , USA

13. , Ulm University, , Germany

14. , Tulane University School of Medicine, , , USA

15. , Boston, , USA

16. Harvard Medical School, , , USA

17. , University of Rome Tor Vergata, , Italy

18. , Maastricht University Medical Centre, , The Netherlands

19. , VieCuri Medical Center, , The Netherlands

20. , Baylor School of Medicine, , , USA

21. Institute for Mind and Brain, , India

22. North Wales Department of Psychological Medicine, , , UK

23. , Centre of Postgraduate Medical Education, , Poland

24. , Witten/Herdecke University, Germany

25. , Hospital Universitario San Agustín, , , Spain

26. , The National Hospital for Neurology and Neurosurgery, , , UK

27. , University College London, , UK

28. , University of Iowa Health Care, , , USA

29. , Queen’s University, , , Canada

30. , Utrecht University, , The Netherlands

31. Flare-Health, , The Netherlands

32. , Georgetown University School of Medicine, , , USA

33. Private Practice, , , USA

34. Psychiatric Clinic, , , Slovakia

Abstract

BACKGROUND: A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. OBJECTIVE: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD). METHODS: The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts. RESULTS: A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor. CONCLUSIONS: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

Publisher

IOS Press

Subject

Public Health, Environmental and Occupational Health,Health Policy,General Medicine

Reference38 articles.

1. Enduring sexual dysfunction after treatment with antidepressants, 5𝛼-reductase inhibitors and isotretinoin: 300 cases;Healy;Int J Risk Saf Med,2018

2. Persistent sexual arousal syndrome. A newly discovered pattern of female sexuality;Leiblum;J Sex Marital Ther,2001

3. Persistent sexual side effects after SSRI discontinuation;Csoka;Psychother Psychosom,2006

4. Post SSRI sexual dysfunction;Bahrick;American Society for the Advancement of Pharmacotherapy Tablet,2006

5. Persistent sexual side effects of finasteride for male pattern hair loss;Irwig;J Sex Med,2011

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