Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies

Simonsen, Anders Lykkemark; Danborg, Pia Brandt; Gøtzsche, Peter C

doi:10.3233/jrs-160668

Cited by 17 publications

(7 citation statements)

References 41 publications

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“…SSRIs cause sexual dysfunction in a large proportion of users, and more worryingly, some people report that this persists after stopping the drug (Bala, Nguyen, & Hellstrom, 2018). This is consistent with research with young animals finding that sexual behaviour is negatively impacted by previous use of SSRIs (Simonsen, Danborg, & Gotzsche, 2016). The prevalence of persistent effects is unknown, but even if it is rare, it is a potential catastrophe given the huge numbers now using antidepressants, and the increasing number of younger users.…”

Section: Antidepressantssupporting

confidence: 91%

Depression: why drugs and electricity are not the answer

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2022

Psychol. Med.

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The dominant view within mental health services and research suggests that feeling depressed is a kind of medical illness, partially caused by various biological deficits which are somehow corrected by physical interventions. This article critically appraises evidence for the effectiveness and value of antidepressant drugs and electroconvulsive therapy (ECT), the two principle physical treatments recommended for depression. It also describes the negative effects of these interventions and raises concerns about how they impact the brain. We propose an alternative understanding that recognises depression as an emotional and meaningful response to unwanted life events and circumstances. This perspective demands that we address the social conditions that make depression likely and suggests that a combination of politics and common sense needs to guide us in providing help for one another when we are suffering in this way. This alternative view is increasingly endorsed around the world, including by the United Nations, the World Health Organization and service users who have suffered negative consequences of physical treatments that modify brain functions in ways that are not well-understood.

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Section: Antidepressantssupporting

confidence: 91%

Depression: why drugs and electricity are not the answer

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2022

Psychol. Med.

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“…Animal studies have found that exposure to an SSRI during pregnancy or at an early age produces sexual deficits in adulthood [ 42 ]. A recent study in humans found evidence that there may be similar implications for people exposed to an SSRI in childhood [ 43 ].…”

Section: Post-ssri Asexualitymentioning

confidence: 99%

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

Healy

Bahrick

Bak

et al. 2022

JRS

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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.

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“…; Phillips‐Farfán and Fernández‐Guasti ; Simonsen et al . ). Dopamine levels increase in the NAcS in response to odors emitted by estrus female and during copulation (Pfaus et al .…”

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confidence: 97%

DARPP‐32 in the orchestration of responses to positive natural stimuli

Scheggi

Montis

Gambarana

2018

Journal of Neurochemistry

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Dopamine- and cAMP-regulated phosphoprotein (M 32 kDa, DARPP-32) is an integrator of multiple neuronal signals and plays a crucial role particularly in mediating the dopaminergic component of the systems involved in the evaluation of stimuli and the ensuing elaboration of complex behavioral responses (e.g., responses to reinforcers and stressors). Dopamine neurons can fire tonically or phasically in distinct timescales and in specific brain regions to code different behaviorally relevant information. Dopamine signaling is mediated mainly through the regulation of adenylyl cyclase activity, stimulated by D1-like or inhibited by D2-like receptors, respectively, that modulates cAMP-dependent protein kinase (PKA) function. The activity of DARPP-32 is finely regulated by its phosphorylation at multiple sites. Phosphorylation at the threonine (Thr) 34 residue by PKA converts DARPP-32 into an inhibitor of protein phosphatase 1, while the phosphorylation at the Thr75 residue turns it into an inhibitor of PKA. Thus, DARPP-32 is critically implicated in regulating striatal output in response to the convergent pathways that influence signaling of the cAMP/PKA pathway. This review summarizes some of the landmark and recent studies of DARPP-32-mediated signaling in the attempt to clarify the role played by DARPP-32 in the response to rewarding natural stimuli. Particularly, the review deals with data derived from rodents studies and discusses the involvement of the cAMP/PKA/DARPP-32 pathway in: 1) appetitive food-sustained motivated behaviors, 2) motivated behaviors sustained by social reward, 3) sexual behavior, and 4) responses to environmental enrichment.

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Persistent sexual dysfunction after early exposure to SSRIs: Systematic review of animal studies

Abstract: Our results showed substantial and lasting effects on sexual behaviour in rats after exposure to an SSRI early in life on important sexual outcomes.

Cited by 17 publications

References 41 publications

Depression: why drugs and electricity are not the answer

Depression: why drugs and electricity are not the answer

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

DARPP‐32 in the orchestration of responses to positive natural stimuli

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