Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin - PubMed (original) (raw)

Audrey Bahrick 2, Maarten Bak 3 4, Angelo Barbato 5, Rocco Salvatore Calabrò 6, Barbara M Chubak 7, Fiammetta Cosci 3 8 9, Antonei B Csoka 10, Barbara D'Avanzo 5, Silvia Diviccaro 11, Silvia Giatti 11, Irwin Goldstein 12 13, Heiko Graf 14, Wayne J G Hellstrom 15, Michael S Irwig 16 17, Emmanuele A Jannini 18, Paddy K C Janssen 19 20, Mohit Khera 21, Manoj Therayil Kumar 22, Joanna Le Noury 23, Michał Lew-Starowicz 24, David E J Linden 25, Celine Lüning 26, Dee Mangin 1, Roberto Cosimo Melcangi 11, Omar Walid Muquebil Ali Al Shaban Rodríguez 27, Jalesh N Panicker 28 29, Arianna Patacchini 8, Amy M Pearlman 30, Caroline F Pukall 31, Sanjana Raj 32, Yacov Reisman 33, Rachel S Rubin 34, Rudy Schreiber 35, Stuart Shipko 36, Barbora Vašečková 37, Ahad Waraich 13

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

David Healy et al. Int J Risk Saf Med. 2022.

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.

Keywords: Post-SSRI sexual dysfunction; antidepressants; finasteride; isotretinoin; selective serotonin reuptake inhibitors.

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