Post-SSRI sexual dysfunction &amp; other enduring sexual dysfunctions

Healy, David

doi:10.1017/s2045796019000519

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…In addition, SSRI antidepressants can have negative effects on sexual function and even male fertility (Nørr et al, 2016), often even when treatment is stopped (Healy et al, 2018). They can also affect future sexual relations between men and women (Healy, 2019; Shindel, 2019).…”

Section: Discussionmentioning

confidence: 99%

Delayed ejaculation in men with depressive disorders

Fiala

Lenz

Havelka³

et al. 2022

Andrologia

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Delayed ejaculation (DE) is one of the most difficult disorders to diagnose from male sexual dysfunctions. It is characterized by a significant ejaculation delay or even an inability to achieve ejaculation (AE). It is a disorder that affects men, but it can also have a secondary effect on their wives/partners and possibly their ability to fertilize. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) describes this sexual disorder as ejaculation which is delayed or absent in at least 75% of sexual intercourse during at least 6 months of partner sexual activity without the man's desire (Abdel-Hamid & Ali, 2018). DE itself also brings anxiety and fear to men (Rowland et al., 2010). Delayed ejaculation can be defined as the time it takes a man to reach ejaculation during vaginal penetration. This time is called IELT (intravaginal ejaculation latency time). The 3rd International Sexual Medicine Consultation defined IELT as a period of 20-25 min during which sexual activity lasts. This time was chosen based on the average IELT obtained in studies in the general male population. Some studies report that the normal range for IELT in men is 4-10 min (Perelman, 2016). The exact pathogenesis of DE/AE is not yet known. There are studies that suggest that this sexual disorder may be caused by a congenital disorder, a genetic disease, surgical complications, hormonal disorders, prostate or seminal vesicles inflammations or diseases, or pelvic nerve disorders (Corona et al., 2011). Our study looked at one of the possible causes of DE/AE, and that is hyperprolactinemia caused by antidepressant treatment in depressive disorders. We evaluated the interrelationships between hyperprolactinemia, depressive disorder, and delayed ejaculation or anejaculation. Prolactin (PRL) levels often increase in patients treated with antidepressants. Some male sexual dysfunctions can also be frequently diagnosed in patients with hyperprolactinemia (Fiala, Lenz, Konecna,

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Section: Discussionmentioning

confidence: 99%

Delayed ejaculation in men with depressive disorders

Fiala

Lenz

Havelka³

et al. 2022

Andrologia

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“…35,38 Our sample included two people who suicided and who attributed their motivation to protracted withdrawal symptoms (in one case, persistent sexual dysfunction). 48,49 Affective withdrawal symptoms can be the very same symptoms for which the antidepressant was initially prescribed, implying that some patients may have confused a genuine relapse with a withdrawal syndrome. However, it has been shown that most antidepressant users can distinguish accurately between symptoms of the original disorder and adverse drug effects.…”

Section: Discussionmentioning

confidence: 99%

Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum

Hengartner

Schulthess

Sørensen

et al. 2020

Therapeutic Advances in Psychopharmacology

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Background: Protracted withdrawal syndrome (PWS) after stopping antidepressants (frequently also referred to as post-acute withdrawal syndrome or PAWS) has been described in a few case reports. However, a detailed quantitative analysis of specific symptom manifestations in antidepressant PWS is still lacking. Methods: We extracted patient narratives from a large English-language internet forum SurvivingAntidepressants.org , a peer support site concerned about withdrawal from antidepressants. PWS was ascertained based on diagnostic criteria proposed by Chouinard and Chouinard, specifically ⩾6 months of continuous antidepressant use, with emergence of new and/or more intense symptoms after discontinuation that last beyond the initial 6 weeks of acute withdrawal. We assessed medication history, outcome of PWS, and the prevalence of specific symptoms. Results: In total, n = 69 individual reports of protracted withdrawal were selected for analysis. At time of the subjects’ most recent reports, duration of PWS ranged from 5 to 166 months, mean = 37 months, median = 26 months. Length of time on the antidepressant causing protracted withdrawal ranged from 6 to 278 months, mean = 96 months, and median = 79 months. Throughout the withdrawal experience, affective symptoms, mostly anxiety, depression, emerging suicidality and agitation, were reported by 81%. Somatic symptoms, mostly headache, fatigue, dizziness, brain zaps, visual changes, muscle aches, tremor, diarrhea, and nausea were reported by 75%. Sleep problems (44%) and cognitive impairments (32%) were mentioned less frequently. These broad symptom domains were largely uncorrelated. Conclusion: PWS or PAWS from antidepressants can be severe and long-lasting, and its manifestations clinically heterogeneous. Long-term antidepressant exposure may cause multiple body system impairments. Although both somatic and affective symptoms are frequent, they are mostly unrelated in terms of occurrence. Proper recognition and detection of PWS thus requires a comprehensive assessment of medication history, duration of the withdrawal syndrome, and its various somatic, affective, sleep, and cognitive symptoms.

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“…22 Afeta indivíduos de ambos os sexos, de qualquer idade ou grupo étnico, e pode surgir após uma toma única do SSRI, algumas doses de tratamento ou desenvolver-se até anos depois da exposição ao SSRI. 23 Esta entidade clínica deve ser considerada quando o doente reporta algum grau de disfunção sexual, que não estaria presente antes de iniciar o tratamento antidepressivo com SSRIs e que persiste após a remissão da depressão e da descontinuação do fármaco SSRI, tendo-se concomitantemente excluído qualquer comorbilidade que possa ser responsável por essa disfunção sexual. 22 Waldinger et al (2014) sugeriram a existência de dois subtipos de PSSD.…”

Section: Disfunção Sexual Pós-ssri 21-definição Prevalência E Classif...unclassified

“…13,18 A perturbação de excitação genital persistente não se associa ao aumento do desejo sexual nem a alterações psicológicas, podendo desenvolver-se durante o tratamento antidepressivo com SSRI ou após a sua descontinuação. 17,23 No entanto, na maioria das situações apresenta-se intimamente relacionada com a descontinuação da medicação SSRI e afeta sobretudo as mulheres, sendo mais provável a sua ocorrência durante a menopausa. 23 A síndrome dos genitais inquietos é uma perturbação genital integrada na PSSD que pode ser causada por uma neuropatia sensorial do ramo terminal do nervo pudendo e caracteriza-se por disestesias genitais e sensações genitais pré-ejaculatórias ou pré-orgásmicas, podendo associar-se também a pernas inquietas ou queixas de hiperatividade vesical, que podem persistir por tempo indeterminado após a descontinuação do SSRI.…”

Section: 2-manifestações Clínicasunclassified

Disfunção Sexual Persistente e Antidepressivos Inibidores Seletivos da Recaptação da Serotonina: Mito ou Realidade?

Figueiredo

Freitas

Ferreira³

2022

Gaz Med

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Os antidepressivos inibidores seletivos da recaptação da serotonina são psicofármacos frequentemente utilizados na prática clínica pelas especialidades de Medicina Geral e Familiar e de Psiquiatria no tratamento de perturbações depressivas e de ansiedade. As elevadas prescrições desta classe de antidepressivos resultam do seu concomitante perfil de eficácia, segurança e tolerabilidade.É clinicamente consensual que esta classe farmacológica pode interferir nas várias fases da resposta sexual durante o tratamento antidepressivo. No entanto, têm sido reportados cada vez mais casos na literatura em que a disfunção sexual não é reversível após a suspensão do fármaco, configurando uma nova entidade clínica persistente, cujo substrato patofisiológico se encontra presentemente sob intensa investigação científica. Rever a literatura recentemente publicada neste âmbito e consciencializar os clínicos para esta nova entidade revela-se uma prioridade com potenciais implicações, particularmente ao nível da abordagem de patologias psiquiátricas tão prevalentes na sociedade atual.

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Post-SSRI sexual dysfunction & other enduring sexual dysfunctions

Cited by 15 publications

References 9 publications

Delayed ejaculation in men with depressive disorders

Delayed ejaculation in men with depressive disorders

Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum

Disfunção Sexual Persistente e Antidepressivos Inibidores Seletivos da Recaptação da Serotonina: Mito ou Realidade?

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